动态超声确定内侧半月板后根撕裂拔出固定的最佳膝关节位置

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-03-14 DOI:10.1016/j.knee.2025.02.029

Haruhiko Nakamura, Atsuto Hoshikawa, Kei Sato, Ryota Takei, Risa Matsumoto, Hiroshi Inui, Kazuo Saita

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引用次数: 0

摘要

目的：关节镜下内侧半月板后根撕裂（MMPRT）术后，较大内侧半月板挤压（MME）预测较差的预后。然而，手术中MMPRT减少MME的最佳膝关节位置尚不清楚。我们评估了用于内侧固定的不同膝关节位置的MME。方法选取20例行MMPRT修复术的患者，术前麻醉、固定前（牵引或不牵引）和固定后均行超声检查。在A、B、C和D位测量MMEs(仰卧，腿从床上放下，膝盖弯曲；外翻应力膝；figure-of-four;与仰卧与受伤膝关节分别屈于床上)在不同时间点进行比较。执行手术固定在位置B.ResultsThe术前意味着是因为职位,B, C, D是1.5,1.4,5.8,和3.6毫米,分别,这是因为在A和B明显小于C和D,而居里夫人在C明显大于在D .术中说这是因为,在位置B和C,在牵引,牵引,和post-fixation 1.2和5.5毫米,0.7和4.3毫米,分别和0.9和2.3毫米。结论在MMPRT修复过程中，MMEs在四字形位时增加，而在外翻应力膝关节位时拉出固定时减少。因此，外翻应力膝关节位置适合在MMPRT修复中进行拔出固定。证据水平

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Dynamic ultrasound-based determination of the optimal knee position for pullout fixation of medial meniscus posterior root tears

Purpose

A larger medial meniscus extrusion (MME) predicts a poorer prognosis after arthroscopic pullout fixation for medial meniscus posterior root tears (MMPRT). However, the optimal knee position in surgery for MMPRT to reduce MME is unclear. We evaluated the MME at various knee positions used for medial fixation.

Methods

We enrolled 20 patients who underwent MMPRT repair and performed ultrasonography preoperatively under anaesthesia, before fixation (both with or without traction), and post-fixation. MMEs were measured in positions A, B, C, and D (supine with the leg dropped from the bed with the knee flexed; valgus stress knee; figure-of-four; and supine with the injured knee flexed over the bed, respectively) at different time points and compared. Surgical fixation was performed in Position B.

Results

The preoperative mean MMEs at positions A, B, C, and D were 1.5, 1.4, 5.8, and 3.6 mm, respectively, and MMEs at A and B were significantly smaller than those at C and D, whereas the MME at C was significantly larger than that at D. The intraoperative mean MMEs, at positions B and C, before traction, with traction, and post-fixation were 1.2 and 5.5 mm, 0.7 and 4.3 mm, and 0.9 and 2.3 mm, respectively.

Conclusion

During MMPRT repair, MMEs increased in the figure-of-four position, but decreased with pullout fixation in the valgus stress knee position. Therefore, the valgus stress knee position is suitable for pullout fixation in MMPRT repair.

Level of Evidence

IV.

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.