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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Ramp Lesions of the Medial Meniscus in Patients Undergoing Primary and Revision ACL Reconstruction: Prevalence and Risk Factors
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Ramp Lesions of the Medial Meniscus in Patients Undergoing Primary and Revision ACL Reconstruction: Prevalence and Risk Factors

机译：进行原发性和修订性ACL重建的患者中内侧半月板的斜面病变：患病率和危险因素

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Background: Ramp lesions are peripheral tears of the posterior horn of the medial meniscus that involve the meniscocapsular attachments or red-red zone and typically occur in conjunction with anterior cruciate ligament (ACL) ruptures. Purpose: To identify the prevalence of, and risk factors for, ramp lesions in a large cohort of patients undergoing primary and revision ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: We queried our institutional registry of patients who underwent primary or revision surgical treatment for an ACL injury. Those who underwent preoperative magnetic resonance imaging (MRI) at our facility were included in the study. Clinical details were extracted and verified using electronic records. All preoperative MRI scans were reviewed by a musculoskeletal radiologist for the presence of a ramp lesion. Stable ramp lesions were defined as a peripheral posterior horn medial meniscal tear identified on MRI but either not identifiable with viewing and probing from the anterior portals or, if identified, not displaceable with anteriorly directed probing. Unstable ramp lesions were defined as peripheral posterior horn medial meniscal tears at the meniscocapsular junction that were identifiable at the time of surgery and displaced into the medial compartment with probing. The prevalence of stable and unstable ramp lesions was calculated. Demographic, injury, and imaging parameters were determined using univariate statistics. Results: A total of 372 patients were included. The overall prevalence of ramp lesions was 42% (155/372). Unstable ramp lesions were present in 73 (20%) patients, and stable ramp lesions were present in 82 (22%) patients. The presence of any ramp lesion (stable or unstable) was associated with bone marrow edema of the posteromedial tibia on MRI (odds ratio [OR], 3.0; P & .0001), a contact injury mechanism (OR, 1.8; P = .02), and a concurrent lateral meniscal tear (OR, 1.7; P = .02). No demographic, injury, surgical, or radiological variable was associated with a stable versus unstable ramp lesion. Conclusion: The overall prevalence of a ramp lesion in patients treated for ACL ruptures at our institution was 42%. The presence of bone marrow edema of the posteromedial tibia, a contact injury mechanism, or a lateral meniscal tear should alert surgeons to the potential presence of a medial meniscal ramp lesion.
机译：背景：斜坡损伤是内侧半月板后角的周围撕裂，累及粘膜囊附件或红红色区域，通常与前交叉韧带（ACL）破裂一起发生。目的：确定大量接受原发性和翻版ACL重建的患者中斜道病变的发生率和危险因素。研究设计：案例系列;证据等级，4。方法：我们查询了接受过ACL损伤初次或翻修手术治疗的患者的机构登记。本研究包括在我们工厂接受过术前磁共振成像（MRI）的患者。提取临床细节并使用电子记录进行验证。肌肉骨骼放射科医生检查了所有术前MRI扫描是否存在斜坡病变。稳定的斜道病变定义为在MRI上确定的周围后角内侧半月板撕裂，但通过前门的观察和探测无法识别，或者如果被识别，则不能通过前向探测进行移位。不稳定的斜道病变定义为在粘膜囊交界处的外周后角内侧半月板撕裂，在手术时可辨认并通过探查移入内侧腔室。计算稳定和不稳定的斜坡病变的患病率。人口统计，伤害和影像学参数使用单变量统计数据确定。结果：共纳入372例患者。坡道病变的总患病率为42％（155/372）。 73（20％）位患者存在不稳定的斜道病变，而82（22％）位患者存在稳定的斜道病变。 MRI上存在任何坡道病变（稳定或不稳定）与后内侧胫骨骨髓水肿有关（奇数比[OR]为3.0; P <.0001），一种接触损伤机制（OR为1.8; P = .02），并发同时发生半月板外侧撕裂（OR，1.7; P = .02）。没有人口统计学，伤害，手术或放射学变量与稳定或不稳定的坡道病变相关。结论：在我们机构接受ACL破裂治疗的患者中，斜坡病变的总患病率为42％。后内侧胫骨的骨髓水肿，接触性损伤机制或半月板外侧撕裂的存在应使外科医生警惕内侧半月板坡道病变的潜在可能。

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