背景:研究表明,内侧半月板后根撕裂(MMPRT)与骨的形态特征之间存在关联。然而,股骨远端骨形态与MMPRT的关系,特别是股骨内侧后髁,知之甚少。我们的研究旨在确定股骨内侧后髁的形态学特征与MMPRT之间的关联。
方法:于2021年1月至2022年1月进行了回顾性病例对照研究。在根据纳入和排除标准进行筛选后,分析了两个匹配的组:MMPRT组和孤立的外侧半月板撕裂组。在X光片上测量髋-膝-踝角度(HKA)和Kellgren-Lawrence等级(KLG);胫骨内侧倾斜角(MTSA),胫骨平台内侧深度(MTPD),两组均在磁共振成像(MRI)上测量股骨内侧后髁(RMFPC)的半径。通过使用受试者工作特征(ROC)曲线分析计算曲线下面积(AUC)和预测MMPRT的最佳临界值。
结果:最终分析共包括174例患者(87例MMPRT患者和87例对照)。在RMFPC中显示出显着差异(17.6±1.0与16.2±1.0,p<0.01)和MTSA(6.4±2.0vs.4.0±1.3,p<0.01),大于对照组。MTPD(1.8±0.6vs.2.9±0.7,p<0.01)和HKA(175.4±2.2vs.损伤组179.0±2.7,p<0.01)与对照组比较差异有显著性,均低于对照组。然而,在KLG上的MMPRT和对照组之间(2.3±0.6vs.2.2±0.6,p=0.209),差异无统计学意义。其中,通过ROC曲线分析,RMFPC截止值计算为16.8mm,敏感性和特异性均为81.61%。
结论:这项研究表明,较大的RMFPC,MTSA,较小的MTPD,和HKA都与MMPRT有关,RMFPC≥16.8mm被认为是MMPRT的重要危险因素。
BACKGROUND: Studies have shown an association between medial meniscus posterior root tears (MMPRT) and morphologic characteristics of the bone. However, the association between distal femoral bone morphology and MMPRT, particularly the medial femoral posterior condyle, is poorly understood. Our study aimed to determine the association between the morphologic characteristics of the medial posterior femoral condyle and MMPRT.
METHODS: A retrospective case-control study was performed from January 2021 to January 2022. After screening based on the inclusion and exclusion criteria, two matched groups were analyzed: the MMPRT group and the isolated lateral meniscus tears group. The hip-knee-ankle angle (HKA) and Kellgren-Lawrence grade (KLG) were measured on radiographs; the medial tibial slope angle (MTSA), medial tibial plateau depth (MTPD), and
radius of the medial femoral posterior condyle (RMFPC) were measured on magnetic resonance imaging (MRI) in both groups. The area under the curve (AUC) and the best cutoff value for predicting MMPRT were calculated by using receiver operating characteristic (ROC) curve analysis.
RESULTS: The final analysis included a total of 174 patients (87 MMPRT patients and 87 controls). Significant differences were shown in the RMFPC (17.6 ± 1.0 vs. 16.2 ± 1.0, p < 0.01) and MTSA (6.4 ± 2.0 vs. 4.0 ± 1.3, p < 0.01), which were larger than those of the control group. The MTPD (1.8 ± 0.6 vs. 2.9 ± 0.7, p < 0.01) and HKA (175.4 ± 2.2 vs. 179.0 ± 2.7, p < 0.01) of the injury group were significantly different from the control group, and both were lower than the control group. However, between the MMPRT and control groups on the KLG (2.3 ± 0.6 vs. 2.2 ± 0.6, p = 0.209), there was no statistically significant difference. Among them, the RMFPC cutoff value was calculated to be 16.8 mm by ROC curve analysis, and the sensitivity and specificity were both 81.61%.
CONCLUSIONS: This study demonstrated that larger RMFPC, MTSA, smaller MTPD, and HKA were all associated with MMPRT, and RMFPC ≥ 16.8 mm was considered as a significant risk factor for MMPRT.