{"title":"外侧半月板后角的前方活动度与腘绳肌前筋膜和腘绳肌后上筋膜的异常磁共振成像结果以及捕捉或锁定症状的临床病史有关","authors":"Jun Suganuma M.D. , Ryuta Mochizuki M.D.","doi":"10.1016/j.asmr.2024.100922","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To identify predictors of anterior mobility of the posterior horn of the lateral meniscus (PHLM) among patient demographics (age, sex), clinical characteristics (a history of catching or locking symptoms [CLS], body mass index, alignment of limb), and magnetic resonance imaging (MRI) findings of 4 restraints: anteroinferior popliteomeniscal fascicle (aiPMF), posterosuperior popliteomeniscal fascicle (psPMF), posteroinferior popliteomeniscal fascicle (piPMF), and meniscofibular ligament (MFibL).</p></div><div><h3>Methods</h3><p>Between October 2010 and December 2014, patients who underwent arthroscopic measurement of mobility of the PHLM were identified. The Sakai classification was used to classify aiPMF and psPMF on MRI into the following 3 types: type A, the fascicle was depicted with obvious continuity and with a low-intensity band; type B, depicted with continuity but with an ambiguous intensity structure; and type C, depicted with discontinuity or not visible. Magnetic resonance images of the piPMF and MFibL were evaluated as presence or absence. The mobility of the PHLM was measured arthroscopically at traction forces of 10 and 20 N.</p></div><div><h3>Results</h3><p>A total of 73 patients (47 men, mean age 41.8 ± 19.3 years) were included. Multivariate regression analyses revealed aiPMF type C and psPMF types B and C to be independent factors associated with mobility at both traction forces, and CLS was an independent factor at a traction force of 20 N. Compared with that of type A, the increased mobility of aiPMF type C was 5.0 mm (<em>P</em> = .019) and 5.6 mm (<em>P</em> = .011) at 10 and 20 N, respectively; the increased mobility of psPMF type B was 2.5 mm (<em>P</em> = .007) and 3.5 mm (<em>P</em> = .0003), respectively; and the increased mobility of psPMF type C was 3.3 mm (<em>P</em> = .021) and 3.6 mm (<em>P</em> = .014), respectively. The increased mobility associated with CLS was 3.5 mm at 20 N (<em>P</em> = .022).</p></div><div><h3>Conclusions</h3><p>Anterior displacement of the PHLM induced by an external traction force at 90° of flexion of the knee joint was associated with abnormal MRI findings of the anteroinferior popliteomeniscal fascicle and posterosuperior popliteomeniscal fascicle, as well as a history of catching or locking symptoms.</p></div><div><h3>Clinical Relevance</h3><p>Understanding signs and symptoms and associated pathology in patients with symptomatic anterior mobility of the posterior horn of the lateral meniscus may help guide best treatment.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000403/pdfft?md5=fe5f094bfd65a4a8b1f05a1e70370de1&pid=1-s2.0-S2666061X24000403-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Anterior Mobility of the Posterior Horn of the Lateral Meniscus Is Associated With Abnormal Magnetic Resonance Imaging Findings of Anteroinferior Popliteomeniscal Fascicle and Posterosuperior Popliteomeniscal Fascicle as Well as a Clinical History of Catching or Locking Symptoms\",\"authors\":\"Jun Suganuma M.D. , Ryuta Mochizuki M.D.\",\"doi\":\"10.1016/j.asmr.2024.100922\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>To identify predictors of anterior mobility of the posterior horn of the lateral meniscus (PHLM) among patient demographics (age, sex), clinical characteristics (a history of catching or locking symptoms [CLS], body mass index, alignment of limb), and magnetic resonance imaging (MRI) findings of 4 restraints: anteroinferior popliteomeniscal fascicle (aiPMF), posterosuperior popliteomeniscal fascicle (psPMF), posteroinferior popliteomeniscal fascicle (piPMF), and meniscofibular ligament (MFibL).</p></div><div><h3>Methods</h3><p>Between October 2010 and December 2014, patients who underwent arthroscopic measurement of mobility of the PHLM were identified. The Sakai classification was used to classify aiPMF and psPMF on MRI into the following 3 types: type A, the fascicle was depicted with obvious continuity and with a low-intensity band; type B, depicted with continuity but with an ambiguous intensity structure; and type C, depicted with discontinuity or not visible. Magnetic resonance images of the piPMF and MFibL were evaluated as presence or absence. The mobility of the PHLM was measured arthroscopically at traction forces of 10 and 20 N.</p></div><div><h3>Results</h3><p>A total of 73 patients (47 men, mean age 41.8 ± 19.3 years) were included. Multivariate regression analyses revealed aiPMF type C and psPMF types B and C to be independent factors associated with mobility at both traction forces, and CLS was an independent factor at a traction force of 20 N. Compared with that of type A, the increased mobility of aiPMF type C was 5.0 mm (<em>P</em> = .019) and 5.6 mm (<em>P</em> = .011) at 10 and 20 N, respectively; the increased mobility of psPMF type B was 2.5 mm (<em>P</em> = .007) and 3.5 mm (<em>P</em> = .0003), respectively; and the increased mobility of psPMF type C was 3.3 mm (<em>P</em> = .021) and 3.6 mm (<em>P</em> = .014), respectively. The increased mobility associated with CLS was 3.5 mm at 20 N (<em>P</em> = .022).</p></div><div><h3>Conclusions</h3><p>Anterior displacement of the PHLM induced by an external traction force at 90° of flexion of the knee joint was associated with abnormal MRI findings of the anteroinferior popliteomeniscal fascicle and posterosuperior popliteomeniscal fascicle, as well as a history of catching or locking symptoms.</p></div><div><h3>Clinical Relevance</h3><p>Understanding signs and symptoms and associated pathology in patients with symptomatic anterior mobility of the posterior horn of the lateral meniscus may help guide best treatment.</p></div>\",\"PeriodicalId\":34631,\"journal\":{\"name\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24000403/pdfft?md5=fe5f094bfd65a4a8b1f05a1e70370de1&pid=1-s2.0-S2666061X24000403-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24000403\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X24000403","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的在患者人口统计学特征(年龄、性别)、临床特征(抓握或锁定症状[CLS]病史、体重指数、肢体排列)和磁共振成像(MRI)结果的 4 个限制因素中,确定外侧半月板后角(PHLM)前方活动度的预测因素:腘绳肌前筋膜(aiPMF)、腘绳肌后上筋膜(psPMF)、腘绳肌后下筋膜(piPMF)和半月板腓肠肌韧带(MFibL)。方法对 2010 年 10 月至 2014 年 12 月间接受关节镜测量 PHLM 活动度的患者进行鉴定。采用 Sakai 分类法将 MRI 上的 aiPMF 和 psPMF 分为以下 3 种类型:A 型,筋膜带具有明显的连续性,且呈低强度带;B 型,筋膜带具有连续性,但强度结构模糊;C 型,筋膜带不连续或不可见。对 piPMF 和 MFibL 的磁共振图像评估为存在或不存在。在关节镜下测量 PHLM 的活动度,牵引力分别为 10 N 和 20 N。结果 共纳入 73 名患者(47 名男性,平均年龄为 41.8 ± 19.3 岁)。多变量回归分析显示,aiPMF C型和psPMF B型和C型是在两种牵引力下与活动度相关的独立因素,而CLS是在20 N牵引力下的独立因素。0 mm (P = .019) 和 5.6 mm (P = .011);psPMF B 型增加的活动度分别为 2.5 mm (P = .007) 和 3.5 mm (P = .0003) ;psPMF C 型增加的活动度分别为 3.3 mm (P = .021) 和 3.6 mm (P = .014)。结论膝关节屈曲90°时,外牵引力引起的PHLM前移位与腘绳肌前筋膜和腘绳肌后筋膜的MRI异常发现以及抓握或锁定症状病史有关。临床意义了解有症状的外侧半月板后角前移患者的症状和体征及相关病理变化有助于指导最佳治疗。
Anterior Mobility of the Posterior Horn of the Lateral Meniscus Is Associated With Abnormal Magnetic Resonance Imaging Findings of Anteroinferior Popliteomeniscal Fascicle and Posterosuperior Popliteomeniscal Fascicle as Well as a Clinical History of Catching or Locking Symptoms
Purpose
To identify predictors of anterior mobility of the posterior horn of the lateral meniscus (PHLM) among patient demographics (age, sex), clinical characteristics (a history of catching or locking symptoms [CLS], body mass index, alignment of limb), and magnetic resonance imaging (MRI) findings of 4 restraints: anteroinferior popliteomeniscal fascicle (aiPMF), posterosuperior popliteomeniscal fascicle (psPMF), posteroinferior popliteomeniscal fascicle (piPMF), and meniscofibular ligament (MFibL).
Methods
Between October 2010 and December 2014, patients who underwent arthroscopic measurement of mobility of the PHLM were identified. The Sakai classification was used to classify aiPMF and psPMF on MRI into the following 3 types: type A, the fascicle was depicted with obvious continuity and with a low-intensity band; type B, depicted with continuity but with an ambiguous intensity structure; and type C, depicted with discontinuity or not visible. Magnetic resonance images of the piPMF and MFibL were evaluated as presence or absence. The mobility of the PHLM was measured arthroscopically at traction forces of 10 and 20 N.
Results
A total of 73 patients (47 men, mean age 41.8 ± 19.3 years) were included. Multivariate regression analyses revealed aiPMF type C and psPMF types B and C to be independent factors associated with mobility at both traction forces, and CLS was an independent factor at a traction force of 20 N. Compared with that of type A, the increased mobility of aiPMF type C was 5.0 mm (P = .019) and 5.6 mm (P = .011) at 10 and 20 N, respectively; the increased mobility of psPMF type B was 2.5 mm (P = .007) and 3.5 mm (P = .0003), respectively; and the increased mobility of psPMF type C was 3.3 mm (P = .021) and 3.6 mm (P = .014), respectively. The increased mobility associated with CLS was 3.5 mm at 20 N (P = .022).
Conclusions
Anterior displacement of the PHLM induced by an external traction force at 90° of flexion of the knee joint was associated with abnormal MRI findings of the anteroinferior popliteomeniscal fascicle and posterosuperior popliteomeniscal fascicle, as well as a history of catching or locking symptoms.
Clinical Relevance
Understanding signs and symptoms and associated pathology in patients with symptomatic anterior mobility of the posterior horn of the lateral meniscus may help guide best treatment.