前交叉韧带撕裂患者中半月板Ramp损伤在MRI上比关节镜更常见。
简介
本研究回顾579例ACL重建患者，对比术前MRI与术中关节镜对半月板ramp lesion的检出率，结果显示MRI检出率（43.2%）远高于术中（9.8%），其中Greif 1、2型稳定型损伤均未在术中得到证实，而MRI上胫骨后内侧骨挫伤是ramp lesion的独立预测因素（OR=4.04）。临床提示：术前MRI判读ramp lesion需谨慎，尤其稳定型…
英文摘要
PURPOSE: To assess the prevalence of, and factors associated with, meniscal ramp lesions in patients with anterior cruciate ligament (ACL) tears. METHODS: All patients who underwent primary ACL reconstruction (ACLR) during 2018 were evaluated. Preoperative magnetic resonance imaging (MRI) scans and surgical reports were reviewed searching for the presence of meniscal ramp lesions. The Greif classification was applied to MRI-detected lesions. Univariable and multivariable logistic regression analyses, and a backward logistic regression analysis, were used to evaluate the associations between patient characteristics and concomitant knee injuries and the presence of meniscal ramp lesions on MRI and at ACLR, respectively. RESULTS: Of the 579 patients included in this study (51.0% men; mean age 28.4 ± 11.4), 250 (43.2%) meniscal ramp lesions were diagnosed on MRI, and 57 (9.8%) were diagnosed at ACLR. None of the 25 MRI-detected Greif´s type 1 and 2 meniscal ramp lesions were confirmed intraoperatively. Posteromedial tibial bone bruising increased likelihood of having meniscal ramp lesions on MRI (odds radio 4.04, 95% confidence intervals 2.85-5.76; P < .001) and at ACLR (odds radio 2.29, 95% confidence intervals 1.29-4.19; P < .01). CONCLUSIONS: Meniscal ramp lesions were frequently detected on MRI in patients undergoing ACL reconstruction, although less commonly observed at the time of surgery. MRI-detected stable meniscal ramp lesions according to the Greif classification (type 1 and 2) showed poor surgical correlation, with no lesions identified at subsequent arthroscopy. Posteromedial tibial bone bruising on MRI was associated with the presence of meniscal ramp lesions both on MRI and at surgery. LEVEL OF EVIDENCE: Level III, retrospective cohort study.