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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Incidence, Presentation, and Treatment of Pediatric and Adolescent Meniscal Root Injuries
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Incidence, Presentation, and Treatment of Pediatric and Adolescent Meniscal Root Injuries

机译：小儿和青少年半月板牙根损伤的发生率，表现和治疗

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Background: Despite the increasing incidence of sports-related knee injuries in youth athletes, few studies have reported on the diagnosis and treatment of pediatric and adolescent meniscal root injuries. Purpose: To describe traumatic posterior meniscal root injuries in a pediatric and adolescent population and compare the presentation of meniscal root injuries versus that of nonroot injuries. Study Design: Cohort study; Level of evidence, 3. Methods: A study was conducted of all knee arthroscopies performed on consecutive patients treated in a pediatric sports practice from March 2012 through February 2015. All patients who were younger than 20 years at the time of their injury and who underwent an arthroscopy with meniscal injury were included. Patients with discoid lateral meniscus, atraumatic meniscal cysts, partial-thickness meniscal root injuries (LaPrade type 1), and recurrent root tears were excluded. A comparative analysis of root and nonroot injuries was performed. Results: A total of 314 patients had surgery for meniscal injury (mean patient age, 16.0 years; range, 10.5-19.6 years). Of these patients, 58 (18.5%) posterior meniscal root injuries were identified. The root injuries were more likely to have joint line tenderness on preliminary physical examination compared with nonroot injuries (96.5% vs 58.6%, respectively; P & .001). Root injuries rarely occurred in isolation compared with nonroot meniscal tears (6.9% vs 17.6%; P = .021) and were frequently treated in combination with anterior cruciate ligament (ACL) injuries (86.2%). Lateral root injuries occurred more often in conjunction with ACL injuries compared with medial root injuries (84.8% vs 22.2%; P & .001). On review of preoperative imaging, meniscal extrusion occurred more often in root injuries than in nonroot injuries (32.8% vs 3.5%; P & .0001) and was uncommonly seen in the skeletally immature patient. Extrusion was seen more often in medial than lateral root tears (66.7% vs 21.7%; P = .008). A majority of patients (57/58) underwent transosseous suture repair of the meniscal root. Conclusion: When treating a pediatric or adolescent patient for a traumatic meniscal tear, a surgeon may expect to see a posterior meniscal root injury in as many as 1 in 6 patients. When treated for an ACL, contact, or multiligament injury or meniscal extrusion, a pediatric or adolescent patient may demonstrate a meniscal root avulsion or complex meniscal tear. These data provide practitioners with an improved ability to identify and treat meniscal root injuries that otherwise lead to rapid cartilage degeneration.
机译：背景：尽管青年运动员与运动有关的膝关节损伤发生率增加，但很少有关于儿童和青少年半月板根部损伤的诊断和治疗的报道。目的：描述小儿和青少年人群的外伤性半月​​板后根损伤，并比较半月板根损伤与非根部损伤的表现。研究设计：队列研究;证据等级，3。方法：对自2012年3月至2015年2月在小儿运动实践中接受治疗的连续患者进行的所有膝关节镜检查均进行了研究。受伤时年龄小于20岁且接受了手术的所有患者包括半月板损伤的关节镜检查。盘状外侧半月板，无创伤性半月板囊肿，部分厚度半月板根部损伤（LaPrade 1型）和复发性眼泪的患者被排除在外。进行了根和非根损伤的比较分析。结果：总共314例接受半月板损伤手术（平均患者年龄16.0岁;范围10.5-19.6岁）。在这些患者中，确定了58名（18.5％）后半月板后根损伤。与非根部损伤相比，根部损伤在初步身体检查时更容易出现关节痛（分别为96.5％和58.6％; P <.001）。与无根半月板撕裂相比，根损伤很少单独发生（6.9％比17.6％; P = .021），并且经常与前交叉韧带（ACL）损伤联合治疗（86.2％）。与内侧根部损伤相比，外侧根部损伤与ACL损伤相结合的发生率更高（84.8％对22.2％; P <.001）。在回顾术前成像时，半月板挤压发生在根部损伤中比非根部损伤中更常见（32.8％vs 3.5％; P ＜.0001），并且在骨骼未成熟的患者中很少见到。挤压比内侧根部撕裂更常见（66.7％vs 21.7％; P = 0.008）。大多数患者（57/58）接受了经皮半月板根部缝合修复。结论：当治疗小儿或青少年患者的半月板创伤性撕裂时，外科医生可能会期望每6名患者中有1名出现半月板后根损伤。当治疗ACL，接触性或多韧带损伤或半月板挤压时，小儿或青少年患者可能表现出半月板根部撕脱或复杂的半月板撕裂。这些数据为从业人员提供了提高的识别和治疗半月板根部损伤的能力，这些损伤否则会导致快速的软骨变性。

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