内侧半月板后根撕裂与胫骨内侧后斜度变陡和内翻对齐有关

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-02-01 DOI:10.1016/j.asmr.2024.100998

Felicitas Allende M.D. , José Rafael García B.S. , Salvador González Ayala B.S. , Lika Dzidzishvili M.D., Ph.D. , Gonzalo Quiroga M.D. , Sachin Allahabadi M.D. , Jorge Chahla M.D., Ph.D.

{"title":"内侧半月板后根撕裂与胫骨内侧后斜度变陡和内翻对齐有关","authors":"Felicitas Allende M.D. , José Rafael García B.S. , Salvador González Ayala B.S. , Lika Dzidzishvili M.D., Ph.D. , Gonzalo Quiroga M.D. , Sachin Allahabadi M.D. , Jorge Chahla M.D., Ph.D.","doi":"10.1016/j.asmr.2024.100998","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze a series of cases with and without medial meniscal posterior root tears (MMPRTs) to determine whether varus alignment and increased sagittal medial tibial slope (MTS) are risk factors for MMPRTs.</div></div><div><h3>Methods</h3><div>The study evaluated 2 groups of patients: The tear group included patients with arthroscopically confirmed MMPRTs, and the no-tear group consisted of control patients matched to the tear group who underwent similar imaging but did not have meniscal root tears. Age, sex, side of injury, and body mass index were recorded for all cases. Preoperative joint space height and Kellgren-Lawrence grade were measured on radiographs. Group matching was performed based on demographic factors (age, sex, and body mass index), joint space height, and Kellgren-Lawrence grade. Mechanical axis measurements were determined from full-limb-length radiographs. MTS was analyzed on preoperative magnetic resonance imaging. Two observers performed the measurements on 2 separate occasions, and intraobserver reliability and interobserver reliability were analyzed using the intraclass correlation coefficient (ICC). Multivariate regression analysis was performed to identify potential risk factors associated with MMPRTs.</div></div><div><h3>Results</h3><div>Of the 142 matched patients included, 76 had root tears (tear group) and 66 did not (no-tear group). Both mechanical axis (183.2° ± 3.2° vs 181.2° ± 2.3°) and MTS (4° ± 1.9° vs 2.4° ± 2.5°) measurements were significantly greater in the tear group (<em>P</em> < .01 for each). However, despite the statistical significance, the small degrees of difference between the groups raises questions about the clinical significance. The intraobserver ICCs were 0.98 and 0.99 for mechanical axis and 0.87 and 0.98 for MTS. The interobserver ICCs showed excellent reliability for mechanical axis (0.95) and good reliability for MTS (0.77). The lower intraobserver and interobserver reliabilities for MTS measurements also suggest a higher likelihood of error. The multivariate logistic regression model indicated that the risk of sustaining an MMPRT increased with varus alignment (odds ratio, 1.268; 95% confidence interval, 1.104-1.478; <em>P</em> = .001) and increased MTS (odds ratio, 1.364; 95% confidence interval, 1.137-1.677; <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>In this study, MMPRTs were associated with varus alignment and steeper MTS. However, the clinical significance of these associations may be limited owing to the small differences between the groups.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case-control study.</div></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"7 1","pages":"Article 100998"},"PeriodicalIF":0.0000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medial Meniscal Posterior Root Tears Are Associated With Steeper Medial Posterior Tibial Slope and Varus Alignment\",\"authors\":\"Felicitas Allende M.D. , José Rafael García B.S. , Salvador González Ayala B.S. , Lika Dzidzishvili M.D., Ph.D. , Gonzalo Quiroga M.D. , Sachin Allahabadi M.D. , Jorge Chahla M.D., Ph.D.\",\"doi\":\"10.1016/j.asmr.2024.100998\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To analyze a series of cases with and without medial meniscal posterior root tears (MMPRTs) to determine whether varus alignment and increased sagittal medial tibial slope (MTS) are risk factors for MMPRTs.</div></div><div><h3>Methods</h3><div>The study evaluated 2 groups of patients: The tear group included patients with arthroscopically confirmed MMPRTs, and the no-tear group consisted of control patients matched to the tear group who underwent similar imaging but did not have meniscal root tears. Age, sex, side of injury, and body mass index were recorded for all cases. Preoperative joint space height and Kellgren-Lawrence grade were measured on radiographs. Group matching was performed based on demographic factors (age, sex, and body mass index), joint space height, and Kellgren-Lawrence grade. Mechanical axis measurements were determined from full-limb-length radiographs. MTS was analyzed on preoperative magnetic resonance imaging. Two observers performed the measurements on 2 separate occasions, and intraobserver reliability and interobserver reliability were analyzed using the intraclass correlation coefficient (ICC). Multivariate regression analysis was performed to identify potential risk factors associated with MMPRTs.</div></div><div><h3>Results</h3><div>Of the 142 matched patients included, 76 had root tears (tear group) and 66 did not (no-tear group). Both mechanical axis (183.2° ± 3.2° vs 181.2° ± 2.3°) and MTS (4° ± 1.9° vs 2.4° ± 2.5°) measurements were significantly greater in the tear group (<em>P</em> < .01 for each). However, despite the statistical significance, the small degrees of difference between the groups raises questions about the clinical significance. The intraobserver ICCs were 0.98 and 0.99 for mechanical axis and 0.87 and 0.98 for MTS. The interobserver ICCs showed excellent reliability for mechanical axis (0.95) and good reliability for MTS (0.77). The lower intraobserver and interobserver reliabilities for MTS measurements also suggest a higher likelihood of error. The multivariate logistic regression model indicated that the risk of sustaining an MMPRT increased with varus alignment (odds ratio, 1.268; 95% confidence interval, 1.104-1.478; <em>P</em> = .001) and increased MTS (odds ratio, 1.364; 95% confidence interval, 1.137-1.677; <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>In this study, MMPRTs were associated with varus alignment and steeper MTS. However, the clinical significance of these associations may be limited owing to the small differences between the groups.</div></div><div><h3>Level of Evidence</h3><div>Level III, retrospective case-control study.</div></div>\",\"PeriodicalId\":34631,\"journal\":{\"name\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"volume\":\"7 1\",\"pages\":\"Article 100998\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24001354\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X24001354","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

目的分析有和无内侧半月板后根撕裂（MMPRTs）的一系列病例，以确定内翻对准和矢状面胫骨内侧斜度（MTS）增加是否是MMPRTs的危险因素。方法本研究分为两组患者：撕裂组包括经关节镜确认的mmprt患者，无撕裂组包括与撕裂组相匹配的对照组患者，这些患者接受了类似的影像学检查，但没有半月板根撕裂。记录所有病例的年龄、性别、损伤部位和体重指数。术前在x线片上测量关节间隙高度和kelgren - lawrence分级。根据人口统计学因素（年龄、性别和体重指数）、关节间隙高度和kelgren - lawrence分级进行分组匹配。机械轴测量由全肢x线片确定。术前磁共振成像分析MTS。两名观察者在两个不同的场合进行测量，使用类内相关系数（ICC）分析观察者内信度和观察者间信度。进行多因素回归分析以确定与MMPRTs相关的潜在危险因素。结果142例患者中，有牙根撕裂76例（撕裂组），无牙根撕裂66例（无撕裂组）。撕裂组机械轴（183.2°±3.2°vs 181.2°±2.3°）和MTS（4°±1.9°vs 2.4°±2.5°）测量值均显著大于撕裂组(P <；每项0.01)。然而，尽管具有统计学意义，但两组之间的微小差异引发了对临床意义的质疑。观察者间的ICCs对机械轴的信度为0.95，对MTS的信度为0.77，对机械轴的信度为0.98，对MTS的信度为0.98。MTS测量的较低观察者内部和观察者之间的可靠性也表明较高的误差可能性。多因素logistic回归模型显示，维持MMPRT的风险随着内翻对齐而增加(优势比，1.268；95%置信区间为1.104 ~ 1.478；P = .001)和MTS升高(优势比1.364；95%置信区间为1.137 ~ 1.677；P = .002)。结论在本研究中，MMPRTs与内翻对准和更陡的MTS相关，然而，由于两组之间的差异较小，这些关联的临床意义可能有限。证据等级：III级，回顾性病例对照研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Medial Meniscal Posterior Root Tears Are Associated With Steeper Medial Posterior Tibial Slope and Varus Alignment

Purpose

To analyze a series of cases with and without medial meniscal posterior root tears (MMPRTs) to determine whether varus alignment and increased sagittal medial tibial slope (MTS) are risk factors for MMPRTs.

Methods

The study evaluated 2 groups of patients: The tear group included patients with arthroscopically confirmed MMPRTs, and the no-tear group consisted of control patients matched to the tear group who underwent similar imaging but did not have meniscal root tears. Age, sex, side of injury, and body mass index were recorded for all cases. Preoperative joint space height and Kellgren-Lawrence grade were measured on radiographs. Group matching was performed based on demographic factors (age, sex, and body mass index), joint space height, and Kellgren-Lawrence grade. Mechanical axis measurements were determined from full-limb-length radiographs. MTS was analyzed on preoperative magnetic resonance imaging. Two observers performed the measurements on 2 separate occasions, and intraobserver reliability and interobserver reliability were analyzed using the intraclass correlation coefficient (ICC). Multivariate regression analysis was performed to identify potential risk factors associated with MMPRTs.

Results

Of the 142 matched patients included, 76 had root tears (tear group) and 66 did not (no-tear group). Both mechanical axis (183.2° ± 3.2° vs 181.2° ± 2.3°) and MTS (4° ± 1.9° vs 2.4° ± 2.5°) measurements were significantly greater in the tear group (P < .01 for each). However, despite the statistical significance, the small degrees of difference between the groups raises questions about the clinical significance. The intraobserver ICCs were 0.98 and 0.99 for mechanical axis and 0.87 and 0.98 for MTS. The interobserver ICCs showed excellent reliability for mechanical axis (0.95) and good reliability for MTS (0.77). The lower intraobserver and interobserver reliabilities for MTS measurements also suggest a higher likelihood of error. The multivariate logistic regression model indicated that the risk of sustaining an MMPRT increased with varus alignment (odds ratio, 1.268; 95% confidence interval, 1.104-1.478; P = .001) and increased MTS (odds ratio, 1.364; 95% confidence interval, 1.137-1.677; P = .002).

Conclusions

In this study, MMPRTs were associated with varus alignment and steeper MTS. However, the clinical significance of these associations may be limited owing to the small differences between the groups.