胫骨平台解剖形态与半月板撕裂的相关性

Relationship between anatomical morphology of the tibial plateau and meniscal tears

背景:半月板撕裂的概率逐渐增加,但目前为止,关于半月板撕裂与胫骨平台解剖形态之间关系的研究较少,且存在争议。目的:测量半月板损伤患者内外侧胫骨平台后倾角和内侧平台凹陷深度以及外侧平台的高度,研究其与半月板损伤的相关性。方法:选择徐州医科大学附属医院2019年9月至2022年6月收治的半月板损伤并行关节镜治疗患者164例,按照损伤情况分为内侧半月板损伤组(n=92)、外侧半月板损伤组(n=45)和内外侧半月板同时损伤组(n=27);选择78例同时期因膝关节痛就诊但无半月板损伤的患者作为对照组。通过MRI图像测量并比较各组内外侧胫骨平台后倾角、内侧胫骨平台凹陷深度和外侧胫骨平台凸出高度。结果与结论:①内侧半月板损伤组的内侧胫骨平台后倾角大于对照组(P<0.05),外侧半月板损伤组的外侧胫骨平台后倾角大于内侧半月板损伤组、对照组(P<0.05),内侧半月板损伤组和对照组的内侧胫骨平台后倾角显著大于外侧平台后倾角(P<0.05);内侧半月板损伤组的内侧胫骨平台深度小于外侧半月板损伤组、对照组(P<0.05),外侧半月板损伤组的外侧胫骨平台凸出高度大于内侧半月板损伤组、对照组(P<0.05);②结果显示,胫骨平台后倾角的增大可能是导致半月板损伤的一个危险因素,而较浅的内侧平台凹陷更容易导致内侧半月板损伤,较高的外侧平台凸出则容易导致外侧半月板损伤。

BACKGROUND:The probability of meniscal tears is gradually increasing.However,the relationship between meniscal tears and the anatomical morphology of the tibial plateau has been poorly studied and controversial so far.OBJECTIVE:To measure the posterior tibial slope,medial tibial plateau depth,and lateral tibial plateau height in patients with meniscal tears and to investigate their association with meniscal tears.METHODS:From September 2019 to June 2022,164 patients with meniscal tears and undergoing arthroscopic treatment were selected from Affiliated Hospital of Xuzhou Medical University.These patients were divided into medial meniscal tears group(n=92),lateral meniscal tears group(n=45)and medial and lateral meniscal tears group(n=27).Totally 78 patients with knee pain without meniscal tears during the same period were selected as the control group.The medial tibial slope,the lateral tibial slope,the medial tibial plateau depth and the lateral tibial plateau height in each group were carefully measured and compared.RESULTS AND CONCLUSION:(1)The medial tibial slope in the medial meniscal tears group was significantly steeper than that in the control group(P<0.05),and the lateral tibial slope in the lateral meniscal tears group was steeper than that in the medial meniscal tears group and the control group(P<0.05).The medial tibial slope of the medial meniscal tears group and the control group was significantly greater than their lateral tibial slope(P<0.05).The medial tibial plateau depth in the medial meniscal tears group was significantly shallower than that in the lateral meniscal tears group and control group(P<0.05),and the lateral tibial plateau height in the lateral meniscal tears group was higher than that in the medial meniscal tears group and control group(P<0.05).(2)These results indicate that steep posterior tibial slope is a risk factor for meniscal tears.A shallow medial tibial plateau depth and a high lateral tibial plateau height have the potential to cause meniscal tears.