Reduced physiological extrusion of the medial meniscus in axial load-bearing condition in anterior cruciate ligament deficiency.

IF 3.3 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-01-01 Epub Date: 2024-05-26 DOI:10.1002/ksa.12269

JiHwan Lee, Gyu Hwan Lee, Farima Zakaryaei, Jae Sung Choi, Jin Goo Kim

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Abstract

Purpose: In this study, ultrasonography was used to measure medial meniscus (MM) extrusion under weight-bearing and nonweight-bearing conditions in both anterior cruciate ligament (ACL)-deficient and ACL-intact knee groups. This study aimed to determine the possible differences between these groups with an eventual impact on meniscal tears in ACL-deficient knees.

Methods: A total of 107 patients who underwent ACL reconstructive surgery between June 2022 and April 2023 were enroled. After applying exclusion criteria, 37 patients met the conditions for inclusion in the study and formed the ACL deficiency group (Group D). Of the 141 patients presenting to an outpatient clinic who agreed to have ultrasonography conducted on their nondiscomforting contralateral knee, 37 patients matched for age, sex, hip-knee-ankle angle and body mass index with Group D patients were selected for the ACL intact group (Group I). Ultrasonography was used to measure MM extrusion in weight-bearing and nonweight-bearing conditions for all participants.

Results: Seventy-four patients were included in the study (n = 37 per group). The supine position showed an MM extrusion of 1.2 ± 0.7 mm in Group I and 1.2 ± 0.7 mm in Group D (not significant). In the standing position, MM extrusion measured 2.0 ± 0.6 mm in Group I and 1.3 ± 0.8 mm in Group D. The difference in extrusion (Δextrusion) between the two positions was 0.8 ± 0.6 in Group I and 0.1 ± 0.2 in Group D, with statistical significance (p < 0.01). A consistent reduction in MM extrusion during weight-bearing was observed in patients with ACL deficiency, irrespective of the duration of ACL deficiency, age, sex and BMI.

Conclusion: ACL deficiency did not significantly impact MM extrusion during nonweight-bearing conditions; however, less MM extrusion was observed in response to axial loading conditions. These findings indicate altered MM biomechanics due to increased anterior-posterior meniscal motion and rotational instability after ACL injury.

Level of evidence: Level III.

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前十字韧带缺损患者在轴向承重状态下内侧半月板的生理性挤压减少。

目的：本研究采用超声波成像技术测量前交叉韧带（ACL）缺损膝关节组和前交叉韧带完好膝关节组在负重和非负重条件下的内侧半月板（MM）挤压情况。本研究旨在确定这两组患者之间可能存在的差异，从而对前交叉韧带缺损膝关节的半月板撕裂产生最终影响：共有 107 名患者在 2022 年 6 月至 2023 年 4 月期间接受了前交叉韧带重建手术。在采用排除标准后，37 名患者符合纳入研究的条件，组成前交叉韧带缺损组（D 组）。在 141 名到门诊就诊并同意对其无不适感的对侧膝关节进行超声波检查的患者中，37 名在年龄、性别、髋-膝-踝角度和体重指数方面与 D 组患者相匹配的患者被选入前交叉韧带完好组（I 组）。超声波检查用于测量所有参与者在负重和非负重条件下的MM挤压情况：研究共纳入 74 名患者（每组 37 人）。仰卧位时，I 组的 MM 挤压为 1.2 ± 0.7 毫米，D 组为 1.2 ± 0.7 毫米（无显著性差异）。在站立姿势下，I 组 MM 挤压量为 2.0 ± 0.6 毫米，D 组为 1.3 ± 0.8 毫米。两种姿势之间的挤压量（Δextrusion）差异为：I 组 0.8 ± 0.6，D 组 0.1 ± 0.2，具有统计学意义（P 结论：前交叉韧带缺损对 MM 挤压量没有显著影响：在非负重条件下，前交叉韧带缺损并不会对MM挤压产生明显影响；但在轴向加载条件下，观察到MM挤压较少。这些研究结果表明，前交叉韧带损伤后，前-后半月板运动增加和旋转不稳定性导致了MM生物力学的改变：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).