Jacob F Oeding, Michael C Dean, Mario Hevesi, Jorge Chahla, Aaron J Krych
{"title":"胫骨内侧平台的斜度更大、Varus对齐度更高、髁间距离和切迹宽度更窄会增加内侧半月板后根撕裂的风险:系统回顾","authors":"Jacob F Oeding, Michael C Dean, Mario Hevesi, Jorge Chahla, Aaron J Krych","doi":"10.1016/j.arthro.2024.10.031","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the available literature on the relationship between knee bony morphology and medial meniscus posterior root tears (MMPRTs) to determine which underlying tibiofemoral morphologic risk factors may predispose the development of MMPRTs.</p><p><strong>Methods: </strong>Embase, MEDLINE, and PubMed databases were searched to identify all relevant human clinical studies investigating knee morphologic features and MMPRTs. Shape features were compared between control groups and patients with MMPRTs. The methodological index for non-randomized studies (MINORS) instrument was utilized to assess the methodological quality of included studies.</p><p><strong>Results: </strong>Thirteen level III evidence studies and one level IV evidence study were included in this review (n=2,181), with 895 patients in the MMPRT group and 1,286 in the control group. Tibial morphology features associated with an increased risk for MMPRTs included an increased medial tibial slope (six studies), increased tibial torsion (one study), increased medial meniscal slope (one study), and shallower medial tibial plateau concavity (one study). Varus mechanical alignment was found to increase the risk for MMPRTs (four studies). Femoral morphology features associated with an increased risk for MMPRTs included an A-type intercondylar notch (one study), increased medial femoral condyle (MFC) angle (one study), narrower intercondylar distance (one study), narrower intercondylar notch width (one study), shorter MFC distal offset distance (one study), increased MFC width (one study), increased MFC to medial tibial condyle width ratio (one study), greater distance between the medial tibial eminence and MFC (one study), and smaller femoral offset ratios of both the medial and lateral condyles (one study).</p><p><strong>Conclusion: </strong>Multiple tibiofemoral shape features, including a steeper slope of the medial tibial plateau, greater varus alignment, and a narrower intercondylar distance and notch width, were found to be predictive factors for MMPRTs.</p><p><strong>Level of evidence: </strong>Level IV (Systematic review of Level III and IV studies).</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Steeper Slope of the Medial Tibial Plateau, Greater Varus Alignment, and Narrower Intercondylar Distance and Notch Width Increase Risk for Medial Meniscus Posterior Root Tears: A Systematic Review.\",\"authors\":\"Jacob F Oeding, Michael C Dean, Mario Hevesi, Jorge Chahla, Aaron J Krych\",\"doi\":\"10.1016/j.arthro.2024.10.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the available literature on the relationship between knee bony morphology and medial meniscus posterior root tears (MMPRTs) to determine which underlying tibiofemoral morphologic risk factors may predispose the development of MMPRTs.</p><p><strong>Methods: </strong>Embase, MEDLINE, and PubMed databases were searched to identify all relevant human clinical studies investigating knee morphologic features and MMPRTs. Shape features were compared between control groups and patients with MMPRTs. The methodological index for non-randomized studies (MINORS) instrument was utilized to assess the methodological quality of included studies.</p><p><strong>Results: </strong>Thirteen level III evidence studies and one level IV evidence study were included in this review (n=2,181), with 895 patients in the MMPRT group and 1,286 in the control group. Tibial morphology features associated with an increased risk for MMPRTs included an increased medial tibial slope (six studies), increased tibial torsion (one study), increased medial meniscal slope (one study), and shallower medial tibial plateau concavity (one study). Varus mechanical alignment was found to increase the risk for MMPRTs (four studies). Femoral morphology features associated with an increased risk for MMPRTs included an A-type intercondylar notch (one study), increased medial femoral condyle (MFC) angle (one study), narrower intercondylar distance (one study), narrower intercondylar notch width (one study), shorter MFC distal offset distance (one study), increased MFC width (one study), increased MFC to medial tibial condyle width ratio (one study), greater distance between the medial tibial eminence and MFC (one study), and smaller femoral offset ratios of both the medial and lateral condyles (one study).</p><p><strong>Conclusion: </strong>Multiple tibiofemoral shape features, including a steeper slope of the medial tibial plateau, greater varus alignment, and a narrower intercondylar distance and notch width, were found to be predictive factors for MMPRTs.</p><p><strong>Level of evidence: </strong>Level IV (Systematic review of Level III and IV studies).</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2024.10.031\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2024.10.031","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
目的:评估膝关节骨性形态与内侧半月板后根撕裂(MMPRTs)之间关系的现有文献,以确定哪些潜在的胫股骨形态风险因素可能会导致MMPRTs的发生:对Embase、MEDLINE和PubMed数据库进行检索,以确定所有调查膝关节形态特征和MMPRTs的相关人类临床研究。比较了对照组和MMPRTs患者的形态特征。利用非随机研究方法指数(MINORS)工具评估纳入研究的方法质量:本综述纳入了 13 项 III 级证据研究和 1 项 IV 级证据研究(n=2,181),其中 MMPRT 组有 895 名患者,对照组有 1,286 名患者。与MMPRTs风险增加相关的胫骨形态特征包括胫骨内侧斜度增加(6项研究)、胫骨扭转增加(1项研究)、内侧半月板斜度增加(1项研究)和胫骨内侧平台凹陷变浅(1项研究)。研究发现,屈曲机械排列增加了MMPRT的风险(四项研究)。与MMPRT风险增加相关的股骨形态特征包括:A型髁间凹槽(一项研究)、股骨内侧髁(MFC)角度增大(一项研究)、髁间距离变窄(一项研究)、髁间凹槽宽度变窄(一项研究)、MFC远端偏移距离更短(一项研究)、MFC宽度增加(一项研究)、MFC与胫骨内侧髁宽度比增加(一项研究)、胫骨内侧突出部与MFC之间的距离更大(一项研究)、股骨内侧和外侧髁的偏移比更小(一项研究)。结论:研究发现,多种胫骨股骨形状特征,包括胫骨内侧平台坡度较陡、曲度较大、髁间距离和切迹宽度较窄,是MMPRTs的预测因素:证据级别:IV级(对III级和IV级研究的系统回顾)。
Steeper Slope of the Medial Tibial Plateau, Greater Varus Alignment, and Narrower Intercondylar Distance and Notch Width Increase Risk for Medial Meniscus Posterior Root Tears: A Systematic Review.
Purpose: To evaluate the available literature on the relationship between knee bony morphology and medial meniscus posterior root tears (MMPRTs) to determine which underlying tibiofemoral morphologic risk factors may predispose the development of MMPRTs.
Methods: Embase, MEDLINE, and PubMed databases were searched to identify all relevant human clinical studies investigating knee morphologic features and MMPRTs. Shape features were compared between control groups and patients with MMPRTs. The methodological index for non-randomized studies (MINORS) instrument was utilized to assess the methodological quality of included studies.
Results: Thirteen level III evidence studies and one level IV evidence study were included in this review (n=2,181), with 895 patients in the MMPRT group and 1,286 in the control group. Tibial morphology features associated with an increased risk for MMPRTs included an increased medial tibial slope (six studies), increased tibial torsion (one study), increased medial meniscal slope (one study), and shallower medial tibial plateau concavity (one study). Varus mechanical alignment was found to increase the risk for MMPRTs (four studies). Femoral morphology features associated with an increased risk for MMPRTs included an A-type intercondylar notch (one study), increased medial femoral condyle (MFC) angle (one study), narrower intercondylar distance (one study), narrower intercondylar notch width (one study), shorter MFC distal offset distance (one study), increased MFC width (one study), increased MFC to medial tibial condyle width ratio (one study), greater distance between the medial tibial eminence and MFC (one study), and smaller femoral offset ratios of both the medial and lateral condyles (one study).
Conclusion: Multiple tibiofemoral shape features, including a steeper slope of the medial tibial plateau, greater varus alignment, and a narrower intercondylar distance and notch width, were found to be predictive factors for MMPRTs.
Level of evidence: Level IV (Systematic review of Level III and IV studies).
期刊介绍:
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