急性前交叉韧带损伤患者的胫骨后部骨质瘀血与后内侧半月板撕裂相关性研究

posterior tibial bone stasis and posterior medial meniscus tears in patients with acute anterior cruciate ligament injury

目的评估在前交叉韧带(ACL)急性断裂的患者中,内侧骨瘀伤是否与后内侧半月板撕裂相关性研究。方法对就诊于马鞍山市人民医院的150名在前交叉韧带断裂后8周内进行MRI扫描并接受前交叉韧带重建的连续患者进行了回顾性分析。根据术中的发现,确定了两组。试验组(n=75)急性前交叉韧带断裂相关的后中轴半月板撕裂,对照组(n=75)重建前交叉韧带。所有患者的术前MRI扫描都被检查了以下解剖部位的骨质瘀伤:股骨外侧髁(LFC)、胫骨外侧平台(LTP)、股骨内侧髁(MFC)和胫骨内侧平台(MTP)。结果MTP骨质瘀伤在急性前交叉韧带损伤后内侧半月板撕裂的病例中更为普遍(P=0.046)。在半月板后内侧撕裂的患者中,MTP 2级或3级骨瘀血更常见(P=0.046)。有后内侧半月板撕裂的病例中,MTP 2级或3级骨淤血的发生率略高,但差异无统计学意义(P>0.05),有或没有后内侧半月板撕裂的患者中,LFC、LTP或MFC的骨淤血差异无统计学意义(P>0.05)。结论内侧骨质淤血;尤其是胫骨后平台上的骨质淤血是由于前交叉韧带受伤时的较高损伤力所致。在急性前交叉韧带断裂后的术前MRI成像中发现内侧骨质淤血,应怀疑相关的后内侧半月板撕裂。

ObjectiveTo assess whether medial bone bruising is associated with posterior medial meniscus tears in patients with acute rupture of the anterior cruciate ligament(ACL).MethodsA retrospective analysis was performed on 150 consecutive patients who underwent MRI scans within 8 weeks after cruciate ligament rupture and underwent cruciate ligament reconstruction. Based on intraoperative findings, two groups were identified. Experimental group(n=75)with acute ACL rupture associated with posterior mid-shaft meniscal tear and control group(n=75)with reconstructed ACL. Preoperative MRI scans of all patients were examined for bony bruising at the following anatomical sites: lateral femoral condyle(LFC), lateral tibial plateau(LTP), medial femoral condyle(MFC), and medial tibial plateau(MTP).ResultsMTP bone bruising was more prevalent in cases of medial meniscus tears following acute cruciate ligament injury(P=0.046). MTP grade 2 or 3 bone bruising was more common in patients with posterior medial meniscal tears(P=0.046). The prevalence of MTP grade 2 or 3 bone bruising was slightly higher in cases with posterior medial meniscal tears, although this did not reach statistical significance(P>0.05), and there was no difference in bone bruising in patients with or without posterior medial meniscal tears for LFC, LTP or MFC(P>0.05).ConclusionMedial bone bruising;particularly on the posterior tibial plateau, may be due to the higher injury forces at the time of ACL injury. The finding of medial bone bruising on preoperative MRI imaging following an acute ACL rupture should raise suspicion of an associated posterior medial meniscus tear.