Ramp lesions of the medial meniscus are associated with greater preoperative anterior knee laxity in anterior cruciate ligament injury.

IF 3.3 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-11-07 DOI:10.1002/ksa.12530

Takeo Tokura, Kanto Nagai, Yuichi Hoshino, Kenjiro Okimura, Yuhei Otsuki, Kyohei Nishida, Noriyuki Kanzaki, Takehiko Matsushita, Ryosuke Kuroda

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Abstract

Purpose: To assess the incidence of ramp lesions in anterior cruciate ligament (ACL) injuries and to compare preoperative knee laxity between the patients with and without ramp lesions by using an electromagnetic measurement system (EMS).

Methods: Two hundred six patients who underwent primary ACL reconstruction with preoperative EMS measurements were retrospectively enrolled in the present study. The diagnoses of the ramp lesions were made by arthroscopic inspections. The patients with ramp lesions and no other meniscal lesions were allocated to 'ramp group', and the patients without any meniscal lesions were allocated to 'control group'. Before ACL reconstruction under general anaesthesia, the side-to-side difference (SSD) in anterior tibial translation (ATT) during Lachman test (mm) and tibial acceleration (m/s²) of posterior tibial reduction during the pivot-shift test was measured using the EMS. The SSD in tibial internal/external rotation angle (°) at 30, 60 and 90 were further measured using the EMS. The SSD in ATT using KT-2000 was also measured. Knee laxity measurements were compared between two groups using unpaired Student's t test.

Results: Ramp lesions were observed in 30 patients (14.7%). Subsequently, 17 patients were allocated to 'ramp group' and 77 patients to 'control group', and there were no statistical differences with regard to background demographics. ATT-SSD during Lachman test was significantly greater in 'ramp group' (9.1 [95% confidence interval, CI: 5.7-12.5] mm vs. 6.2 [95% CI: 5.1-7.3] mm, p = 0.037). However, SSD in ATT with KT-2000, tibial acceleration during pivot-shift test, and SSD in tibial rotational angles were not significantly different between the two groups.

Conclusion: Presence of ramp lesion was associated with increased anterior knee laxity during Lachman test, suggesting ramp lesions may need to be addressed at the time of ACL reconstruction.

Level of evidence: IV.

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内侧半月板的斜坡损伤与前交叉韧带损伤患者术前膝关节前部更松弛有关。

目的：使用电磁测量系统（EMS）评估前交叉韧带（ACL）损伤中斜坡病变的发生率，并比较有斜坡病变和无斜坡病变患者的术前膝关节松弛情况：本研究回顾性地纳入了 26 名接受初级前交叉韧带重建术并进行术前 EMS 测量的患者。斜坡病变的诊断是通过关节镜检查做出的。有斜坡病变且无其他半月板病变的患者被分配到 "斜坡组"，无半月板病变的患者被分配到 "对照组"。在全身麻醉下进行前交叉韧带重建前，使用 EMS 测量拉赫曼试验中胫骨前移（ATT）的侧向差（SSD）（毫米）和枢轴移位试验中胫骨后缩的胫骨加速度（米/秒2）。使用 EMS 进一步测量了 30、60 和 90 度时胫骨内/外旋角度（°）的 SSD。此外，还使用 KT-2000 测量了 ATT 的 SSD。使用非配对的学生 t 检验比较两组患者的膝关节松弛测量结果：结果：30 名患者（14.7%）出现斜坡病变。随后，17 名患者被分配到 "斜坡组"，77 名患者被分配到 "对照组"。斜坡组 "在拉赫曼测试中的 ATT-SSD 明显更大（9.1 [95% 置信区间：5.7-12.5] mm vs. 6.2 [95% 置信区间：5.1-7.3] mm，p = 0.037）。然而，两组患者在使用 KT-2000 进行 ATT 时的 SSD、枢轴移位测试时的胫骨加速度和胫骨旋转角度的 SSD 没有显著差异：结论：斜坡病变的存在与Lachman测试中膝前部松弛的增加有关，这表明在前交叉韧带重建时可能需要处理斜坡病变：证据等级：IV。

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).