Background: The menisci of the knee play a critical role in maintaining structural integrity, as well as in load bearing and shock absorption. In adolescent patients, meniscal tear is a very common sports injury, and is frequently associated with concomitant traumatic injuries including tibial eminence fracture or ACL tear. The incidence of pediatric meniscal tears is increasing, and anatomic studies to guide repair, saucerization and transplantation do not exist. Hypothesis/Purpose: This study’s purpose was to evaluate meniscus dimensions in the developing meniscus and provide anatomic parameters for repair, saucerization, resection, transplantation. Methods: From images of 29 dissected cadaveric knee specimens between 1 month and 132 months of age obtained on a copy stand (14 left knee, 15 right knee), we made direct length measurements from the inner to outer meniscus rim at 45 degree intervals (12, 1:30/10:30, 3:00/9:00, 4:30/7:30 o’clock, 6 o’clock) using Autodesk Fusion 360 software (Figure 1.1). We also measured width between the outer medial and lateral meniscus rims, as well as CT measurements of coronal and sagittal width of the tibial plateau using OsiriX DICOM software. Generalized linear models were used to evaluate the associations of meniscal length measurements with age, tibial width, and meniscal width measurements. All statistical analyses were completed with a two-sided level of significance of 0.05. Results: All radial length measurements were predicted to increase significantly with age (p & 0.01), as coronal tibial width increases (p & 0.05), and as lateral-medial meniscal width increases (p & 0.001) (Figure 1.2). Other than the lateral 3 o’clock measurement (p = 0.119), all radial measurements were predicted to increase significantly as sagittal tibial width increases (p & 0.05). The posterior zones of the medial meniscus (6:00, 4:30/7:30) were found to increase in radial length at a faster rate than the anterior zones. The anterior zones of the medial meniscus (12:00, 1:30/10:30) had the slowest rate of growth. Discussion/Conclusion: Meniscus radial length is related to age, tibial plateau width, and lateral-medial meniscus width. Radial dimensions from normal lateral menisci may allow the surgeon to obtain ideal size of resection, saucerization of discoid menisci. The growth of medial meniscus posterior zones is greater than the anterior zones. This may be attributed to increased posterior region load bearing which increases with ambulation in the developing child. Improved anatomic understanding may help surgeons plan for discoid resection/saucerization/repair, and also support appropriate selection of meniscus allograft for transplantation.
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机译：背景：膝盖的半月形在保持结构完整性以及负载轴承和减震方面发挥着关键作用。在青少年患者中，半月膜撕裂是一种非常常见的运动损伤，并且经常与伴随的创伤损伤有关，包括胫骨偏离骨折或ACL撕裂。小儿半月板撕裂的发病率正在增加，并且不存在指导修复，辛化和移植的解剖学研究。假设/目的：本研究的目的是评估开发半月板中的弯月面尺寸，并提供修复，茶柳，切除，移植的解剖学参数。方法：从29个孤立的尸体膝盖标本的图像在副本支架上获得的1个月和132个月（14个左膝盖，15右膝盖），我们以45度的间隔从内半月板边缘直接测量（ 12,1：30/10：30,3：00/9：00，4：30/7：30点，6点钟）使用Autodesk Fusion 360软件（图1.1）。我们还使用Osirix DICOM软件测量外内侧和侧弯液体轮辋之间的宽度，以及胫骨平台的冠状和矢状宽度的CT测量。广义的线性模型用于评估半月板长度测量与年龄，胫骨宽度和半月板宽度测量的关联。所有统计分析都完成了双面显着性0.05。结果：预计所有径向长度测量值随着年龄（P＆amp; 0.01）而显着增加，因为冠状胫骨宽度增加（P＆amp; 0.05），并且作为侧颈宽度增加（P＆amp; LT; LT;; 0.001）（图1.2）。除了横向3点测量（P = 0.119），预计所有径向测量值都随着矢状胫骨宽度的增加而显着增加（P＆amp; 0.05）。内侧半月板（6:00,4：30/7：30）的后部区域被发现以比前段更快的速度增加径向长度。内侧半月板（12:00,1：30/10：30）的前区域具有最慢的增长率。讨论/结论：弯月面径向长度与年龄，胫骨平台宽度和侧内侧弯月面宽度有关。来自正常侧弯型肿瘤的径向尺寸可能允许外科医生获得理想的切除尺寸，无表情肿块肌肉味。内侧弯月面后部区域的生长大于前地区。这可能归因于增加后部的负载轴承，其随着显影子的动手增加而增加。 Improved anatomic understanding may help surgeons plan for discoid resection/saucerization/repair, and also support appropriate selection of meniscus allograft for transplantation.
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