Abstract：
OBJECTIVE: The number of anterior cruciate ligament (ACL) injuries has considerably increased in the recent years, especially in young adults and adolescents. Associated meniscal tears increase anterior and rotary laxity. Posterior peripheral meniscocapsular tear of medial meniscus is also called ramp lesion. Prevalence of 9% to 17% in adults and up to 23% in pediatric population has been reported. The aim of this study was to determine anterior laxity of cadaveric ACL-deficient knees with several size of ramp lesions.
METHODS: Fresh cadaveric knees were explored. Major osteoarthritis and/or ACL and meniscal tears on arthroscopy were exclusion criteria. Mean age at death was 86 years old. Dynamic laximetry with GNRB® device was made in several conditions: Knee prior to any procedure, after arthroscopic exploration, after ACL section, and then after increasing sizes of ramp lesions up to 30 mm. Anteroposterior laxity was measured with 2 loading forces successively (134N and 200N).
RESULTS: After ACL section only, tibiofemoral joint anterior laxity was significantly increased. Mean increase was 156% regardless of the loading force. No statistical laxity difference was found between knees with ACL section only and knees with ACL and meniscal section for any size of ramp lesions. Increasing size of ramp lesion was not correlated with increasing of laxity.
CONCLUSIONS: We could not find a threshold size of ramp lesion which increases knee anterior laxity. We were not able to determine a threshold recommending a ramp lesion repair.
METHODS: Fresh cadaveric knees were explored. Major osteoarthritis and/or ACL and meniscal tears on arthroscopy were exclusion criteria. Mean age at death was 86 years old. Dynamic laximetry with GNRB® device was made in several conditions: Knee prior to any procedure, after arthroscopic exploration, after ACL section, and then after increasing sizes of ramp lesions up to 30 mm. Anteroposterior laxity was measured with 2 loading forces successively (134N and 200N).
RESULTS: After ACL section only, tibiofemoral joint anterior laxity was significantly increased. Mean increase was 156% regardless of the loading force. No statistical laxity difference was found between knees with ACL section only and knees with ACL and meniscal section for any size of ramp lesions. Increasing size of ramp lesion was not correlated with increasing of laxity.
CONCLUSIONS: We could not find a threshold size of ramp lesion which increases knee anterior laxity. We were not able to determine a threshold recommending a ramp lesion repair.
摘要：
目的：近年来，前交叉韧带（ACL）损伤的数量大大增加，尤其是年轻人和青少年。相关的半月板撕裂会增加前部和旋转松弛。内侧半月板的后外周半月板囊撕裂也称为斜坡病变。据报道，成人患病率为9％至17％，儿科人群患病率高达23％。这项研究的目的是确定尸体ACL缺乏的膝盖的前松弛度，这些膝盖有几种斜坡病变。
方法：研究新鲜尸体的膝盖。关节镜检查中的严重骨关节炎和/或ACL和半月板撕裂是排除标准。平均死亡年龄为86岁。使用GNRB®设备的动态环法是在以下几种情况下进行的：任何手术前膝盖，关节镜探查后，在ACL部分之后，然后在斜坡病变的大小增加到30毫米后。依次用2个加载力(134N和200N)测量前后松弛度。
结果：仅在ACL部分之后，胫股关节前松弛度明显增加。无论加载力如何，平均增加156%。对于任何大小的斜坡病变，仅具有ACL部分的膝盖与具有ACL和半月板部分的膝盖之间均未发现统计学上的松弛性差异。斜坡病变的大小增加与松弛度的增加无关。
结论：我们无法找到增加膝前松弛的斜坡病变的阈值大小。我们无法确定推荐斜坡病变修复的阈值。
方法：研究新鲜尸体的膝盖。关节镜检查中的严重骨关节炎和/或ACL和半月板撕裂是排除标准。平均死亡年龄为86岁。使用GNRB®设备的动态环法是在以下几种情况下进行的：任何手术前膝盖，关节镜探查后，在ACL部分之后，然后在斜坡病变的大小增加到30毫米后。依次用2个加载力(134N和200N)测量前后松弛度。
结果：仅在ACL部分之后，胫股关节前松弛度明显增加。无论加载力如何，平均增加156%。对于任何大小的斜坡病变，仅具有ACL部分的膝盖与具有ACL和半月板部分的膝盖之间均未发现统计学上的松弛性差异。斜坡病变的大小增加与松弛度的增加无关。
结论：我们无法找到增加膝前松弛的斜坡病变的阈值大小。我们无法确定推荐斜坡病变修复的阈值。
