最新骨科读书报告

After adjusting for other factors, sex, BMI, mechanical axis angle, and lower sports activity level remained strong determinants of MMPRT.
C o n c lu s io n
C ha ra cte ristic of M M P R
症状隐匿,没有特异的体征,即使进行关节镜检 查也常由于其位置隐蔽,难以接近而漏诊。
轻度屈膝外翻位检查MMPR
a na tom y of M M P R
膝关节MMPR与滑膜的结合部被称为 Ramp区域。
Strobel MJ.Ramp Lesions.Berlin Herdelberg:Springer-Verlag,1998,171-178.
R e s u lts
With regard to radiographic features, the mechanical axis angle demonstrated a significantly increased varus alignment in group 1 compared with group 2 (P﹤.01 )
Demographic characteristics
Demographic characteristics (age, sex, body mass index [BMI]), radiographic features (mechanical axis angle, tibia vara angle, tibial slope angle, and environmental factors (occupation, trauma history, sports activity level, variables that are representative of the orientallifestyle of lotus position and squatting) were surveyed.
容易形成“医源技术性忽略”。
cha ra cte ristics of ra m p le sion
不 会 自 然 愈 合
继续向前方延伸, 形成更大的内侧半月板桶柄样撕裂, 造成整个内侧半月板的撕裂 形成半月板后角的复合性撕裂,造成整个后角的不稳定
Bhattacharyya T, et al. J Bone Joint Surg Am. 2003;85:4-9 Baratz ME, Fu FH. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee: a preliminary report. Am J Sports Med. 1986;14:270-275.
读书报告
报告人：陈帅 导师 ：黄华扬 主任
Risk Factors for Medial Meniscus Posterior Root Tear
内侧半月板后角损伤多因素分析
Byoung-Yoon Hwang, Sung-Jae Kim, Sang-Won Lee, David J. Hunter and Kwang-Am
Bin SI,Shin SJ. Radial tears of the posterior horn of the medial meniscus.Arthroscopy.2004;20:373-378. Utzschneider S,Weber P,et al.Knee Surg Sports Traumatol Arthrosc.2011;19(10):1643-1648.
such as the lotus position or squatting
?
P u rp o s e
The present study was designed to identify the risk factors for MMPRT among an Asian sample.
Cohort study
excluding those with ligament laxity, lateral meniscal tear, systemic arthritis, osteonecrosis,or other combined ligament injury. 564-476 Unfollow-up 16%
C o n c lu s io n
Persons with MMPRT had significantly increased age, female sex predominance, higher BMI, greater varus mechanical axis angle, and lower sports activity level compared with persons with other types of meniscal tear.
a na tom y of M M P R
MMPR的滑膜边缘撕裂又称Ramp损伤， 是其中较为特异的一种，多见于陈旧性 的、病程较长的ACL损伤。
T ypica l ra m p
le sion
C la ssifica tion of ra m p le sion
Ramp损伤常被忽视,有些Ramp损伤即使 被发现! 也由于无法采用常规的半月板修 补缝合方法而被放弃治疗!
assessed the relation of these risk factors to the type of meniscal tear(group 1 or 2).
One hundred four patients had MMPRT (group 1)
the other patients had other types of medial meniscal tears (group 2).
Interestingly, oriental postural positions including the lotus position and squatting showed no contribution to increased risk of MMPRT. This suggests that intrinsic risk factors (similar to those that predispose to osteoarthritis) predispose to MMPRT.
Am J Sports Med 2012 40: 1606 published online May 11, 2012
history re vie w
内侧半月板后角（M e dia l M e niscus P oste rior R oot，M M P R ）位于膝关节后内 间隙，常规膝关节镜入路难于全面观察 到。
M u ltip le lo g is tic re g re s s io n a n a ly s is
M u ltip le lo g is tic re g re s s io n a n a ly s is
female sex was associated with a 5.9-fold increase in riswenku.baidu.com mechanical axis angle with a 3.3-fold increase BMI more than 30 kg/m2 with a 4.9-fold increase lower sports activity level with a 2.7-fold increase
R e s u lts
Environmental factors showed no differences in occupation, except sports activity level. There were 41 patients (42.7%) in group 1 and 77 patients (20.6%) in group 2 who did not participate in any recreational activity (P﹤.01 )
The forgotten corners
A m o n g A s ia n p e o p le
Background: Medial meniscus posterior root tears (MMPRT) have a different clinical effect from other types of meniscal tears. may be related to the frequent use of postures
M e th o d s
An observational study was performed of 476 consecutive patients undergoing an arthroscopic procedure on their medial meniscus from January 2010 to December 2010.
R e s u lts
In group 1, there were 7 male and 97 female patients, with an average age of 58.2 years (range, 39-78 years) and BMI of 26.7±3.4 kg/m2 In group 2, there were 136 male and 236 female patients(P﹤.01 compared with group 1) with an average age of 54.3 years (range, 17-77 years;P﹤.01) and a BMI of 24.9± 3.1 kg/m2
冯华，洪雷，等.中华骨科杂志，2005,25（11）： 651-655. Baldwin JL. Am J Sports Med ,1995,37(12):23552360.
F unction
of M M P R
M M P R 与A C L之间存在生物力学相关 性,共同限制胫骨的前移 传递能量 缓冲
My
e xpe rie nce
1、M M P R -R a m p 损伤症状隐匿，特异性体征
少，尤其对于AC L 陈旧性损伤患者术前M R 检查，矢 状位可以观察到内侧半月板后角与滑膜交界区高信号
2、对于所有ACL损伤病例关节镜检查时应常规采用经髁 间窝或后内侧入路观察内侧半月板后角 3、一旦发现Ramp损伤，应积极进行a ll -in s id e 缝合 手术治疗 4、此文献随访人数之多，时间短