最新骨科读书报告.ppt

读书报告 报告人：陈帅 导师 ：黄华扬 主任 Risk Factors for Medial MeniscusPosterior 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 Am J Sports Med 2012 40: 1606 published online May 11, 2012 history review 内侧半月板后角（Medial Meniscus Posterior Root，MMPR）位于膝关节后内间隙，常规膝关节镜入路难于全面观察到。 Function of MMPR MMPR与ACL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 Characteristic of MMPR 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。 anatomy of MMPR 膝关节MMPR与滑膜的结合部被称为Ramp区域。 anatomy of MMPR 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。 Typical ramp lesion Classification of ramp lesion 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! 容易形成“医源技术性忽略”。 characteristics of ramp lesion 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 The forgotten corners Among Asian people 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 such as the lotus position or squatting ? Purpose The present study was designed to identify the risk factors for MMPRT among an Asian sample. Cohort study Methods An observational study was performed of 476 consecutive patients undergoing an arthroscopic procedure on their medial meniscus from January 2010 to December 2010. excluding those with ligament laxity, lateral meniscal tear, systemic arthritis, osteonecrosis,or other combined ligament injury. 564-476 Unfollow-up 16% 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). 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 lev