Повреждения корня мениска: распространенность и современные аспекты диагностики и лечении
DOI:
https://doi.org/10.52889/1684-9280-2022-3-64-16-22Ключевые слова:
отрыв корня мениска, распространенность, диагностика, ушивание мениска, остеоартрозАннотация
Среди многообразия различных патологий внутрисуставных структур колена, отрывы корня медиального мениска являются одним из самых малоизученных и в то же время самых грозных повреждений. Биомеханически, данный тип травмы сопоставим с тотальной менискэктомией, что приводит к уменьшению площади тибиофеморального контакта и увеличению контактного давления в пораженном месте. Эти изменения губительны для суставного хряща и в конечном итоге приводят к развитию раннего остеоартроза. Хирургическое лечение является методом выбора у пациентов без значительного остеоартроза (1 или 2 степени). По данным многих авторов, восстановление корня улучшает клинические результаты, снижает экструзию мениска и замедляет начало дегенеративных изменений.
Статья предназначена для расширения общей базы знаний по вопросу для специалистов, которые могут столкнуться с данной проблемой.
Библиографические ссылки
Makris E.A., Hadidi P., Athanasiou K.A. The knee meniscus: structure-function, pathophysiology, current repair
techniques, and prospects for regeneration. Biomaterials. 2011; 32(30): 7411-31.
Padalecki J.R., Jansson K.S., Smith S.D., Dornan G.J. et al. Biomechanical consequences of a complete radial tear adjacent
to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med. 2014; 42(3): 699-707.
Marzo J.M., Gurske-DePerio J. Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact
area and peak contact pressure with clinical implications. J Am J Sports Med. 2009; 37(1): 124-129.
Hwang B.Y., Kim S.J., Lee S.W., Lee H.E. et al. Risk factors for medial meniscus posterior root tear. Am J Sports Med. 2012;
(7): 1606-10.
Pagnani M.J., Warren R.F., Arnoczky S.P., Wickiewicz T.L. Anatomy of the knee. In Nicholas JA, Hershman E (eds.), The
Lower Extremity and Spine in Sports Medicine, 2nd ed. St. Louis: Mosby, 1995: 581-614.
Pagnani M.J., Cooper D.E., Warren R.F. Extrusion of the medial meniscus. Arthroscopy: The Journal of Arthroscopic &
Related Surgery. 1991; 7(3): 297-300.
Matheny L.M., Ockuly A.C., Steadman J.R., LaPrade R.F. Posterior meniscus root tears: associated pathologies to assist
as diagnostic tools. Knee Surg Sports Traumatol Arthrosc. 2015; 23(10): 3127-31.
Kim Y.J., Kim J.G., Chang S.H., Shim J.C. et al. Posterior root tear of the medial meniscus in multiple knee ligament
injuries. Knee. 2010; 17(5): 324-328.
Brody J.M., Lin H.M., Hulstyn M.J., Tung G.A. Lateral meniscus root tear and meniscus extrusion with anterior cruciate
ligament tear. Radiology. 2006; 239(3): 805-10.
Kim Y.M., Rhee K.J., Lee J.K., Hwang D.S. et al. Arthroscopic pullout repair of a complete radial tear of the tibial
attachment site of the medial meniscus posterior horn. Arthroscopy: The Journal of Arthroscopic and Related Surgery. 2006; 22(7): 795.E1-795.E4.
LaPrade C.M., Smith S.D., Rasmussen M.T., Hamming M.G. et al. Consequences of tibial tunnel reaming on the meniscal
roots during cruciate ligament reconstruction in a cadaveric model, Part 2: The posterior cruciate ligament. Am J Sports Med. 2015; 43(1): 207-12.
Kim S.B., Ha J.K., Lee S.W., Kim D.W. et al. Medial meniscus root tear refixation: comparison of clinical, radiologic,
and arthroscopic findings with medial meniscectomy. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2011; 27(3): 346-354.
Fox A.J., Bedi A., Rodeo S.A. The basic science of human knee menisci: structure, composition, and function. Sports
health, 2012; 4(4), 340-351.
LaPrade M.D., LaPrade C.M., Hamming M.G., Ellman M.B. et al. Intramedullary Tibial Nailing Reduces the Attachment
Area and Ultimate Load of the Anterior Medial Meniscal Root: A Potential Explanation for Anterior Knee Pain in Female Patients and Smaller Patients. Am J Sports Med. 2015; 43(7): 1670-5.
Krych A.J., Bernard C.D., Kennedy N.I., Tagliero A.J. et al. Medial versus lateral meniscus root tears: is there a difference
in injury presentation, treatment decisions, and surgical repair outcomes? Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2020; 36(4): 1135-1141.
Okazaki Y., Furumatsu T., Yamauchi T., Okazaki Y. et al. Medial meniscus posterior root repair restores the intra articular volume of the medial meniscus by decreasing posteromedial extrusion at knee flexion. Knee Surgery, Sports
Traumatology, Arthroscopy, 2020; 28(11), 3435-3442.
Raj M.A., Bubnis M.A. Knee Meniscal Tears. StatPearls [Internet]. 2022; Treasure Island (FL): StatPearls Publishing.
Jan.
Lee J.H., Lim Y.J., Kim K.B., Kim K.H. et al. Arthroscopic pullout suture repair of posterior root tear of the medial
meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2009; 25(9): 951-958.
Gupta Y., Mahara D., Lamichhane A. McMurray's Test and Joint Line Tenderness for Medial Meniscus Tear: Are They
Accurate? Ethiop J Health Sci. 2016; 26(6): 567-572.
Seil R., Duck K., Pape D. A clinical sign to detect root avulsions of the posterior horn of the medial meniscus. Knee Surg
Sports Traumatol Arthrosc. 2011; 19(12): 2072-5.
Choi S.H., Bae S., Ji S.K., Chang M.J. The MRI findings of meniscal root tear of the medial meniscus: emphasis on
coronal, sagittal and axial images. Knee Surgery, Sports Traumatology, Arthroscopy. 2012; 20(10): 2098-2103.
Lee S.Y., Jee W.H., Kim J.M. Radial tear of the medial meniscal root: reliability and accuracy of MRI for diagnosis.
American Journal of Roentgenology. 2008; 191(1): 81-85.
Nakamura R., Takahashi M., Kuroda K., Katsuki Y. Suture anchor repair for a medial meniscus posterior root tear
combined with arthroscopic meniscal centralization and open wedge high tibial osteotomy. Arthrosc Tech. 2018; 7(7): e755-61.
Pache S., Aman Z.S., Kennedy M., Nakama G.Y. et al. Meniscal Root Tears: Current Concepts Review. Arch Bone Jt Surg.
; 6(4): 250-259.
Mueller B.T., Moulton S.G., O’Brien L., LaPrade R.F. Rehabilitation following meniscal root repair: A clinical commentary.
J Orthop Sports Phys Ther. 2016; 46(2): 104-13.
Krych A.J., Johnson N.R., Mohan R., Hevesi M. et al. Arthritis progression on serial MRIs following diagnosis of medial
meniscal posterior horn root tear. The journal of knee surgery, 2018; 31(07): 698-704.
Ro K.H., Kim J.H., Heo J.W., Lee D.H. Clinical and radiological outcomes of meniscal repair versus partial meniscectomy
for medial meniscus root tears: a systematic review and meta-analysis. Orthopaedic Journal of Sports Medicine, 2020; 8(11): 2325967120962078.
Kim Y.M., Joo Y.B. Pullout failure strength of the posterior horn of the medial meniscus with root ligament tear. Knee
Surg Sports Traumatol Arthrosc. 2013; 21(7): 1546-52.
Lee S.K., Yang B.S., Park B.M., Yeom J.U. et al. Medial Meniscal Root Repair Using Curved Guide and Soft Suture Anchor.
Clinics in orthopedic surgery. 2018; 10(1): 111–115.
Nicholas S.J., Golant A., Schachter A.K., Lee S.J. A new surgical technique for arthroscopic repair of the meniscus root
tear. Knee Surg Sports Traumatol Arthrosc. 2009; 17(12): 1433-1436.
Cerminara A.J., LaPrade C.M., Smith S.D., Ellman M.B. et al. Biomechanical evaluation of a transtibial pull-out meniscal
root repair: Challenging the bungee effect. Am J Sports Med. 2014; 42(12): 2988-2995.
Chung K.S., Ha J.K., Ra H.J., Kim J.G. A meta-analysis of clinical and radiographic outcomes of posterior horn medial
meniscus root repairs. Knee Surg Sports Traumatol Arthrosc. 2016; 24(5): 1455–1468.
Feucht M.J., Kuhle J., Bode G., Mehl J. et al. Arthroscopic Transtibial Pullout Repair for Posterior Medial Meniscus Root
Tears: A Systematic Review of Clinical, Radiographic, and Second-Look Arthroscopic Results. Arthroscopy. 2015; 31(9): 1808-
Feucht M.J., Grande E., Brunhuber J., Rosenstiel N. et al. Biomechanical comparison between suture anchor and
transtibial pull-out repair for posterior medial meniscus root tears. The American journal of sports medicine. 2014; 42(1): 187-193.
Park H.J., Chang M.J., Cho H.J., Hong E. et al. Medial Meniscus Posterior Root Repair Restores Contact Pressure
and Contact Area to Its Native State Even After Opening-Wedge High Tibial Osteotomy: A Cadaveric Biomechanical Study.
Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2022
Allaire R., Muriuki M., Gilbertson L., Harner C.D. Biomechanical consequences of a tear of the posterior root of the
medial meniscus. The Journal of Bone & Joint Surgery. 2008; 90(9): 1922-1931.
Kyun-Ho S., Hyun-Jae R., Ki-Mo J., Seung-Beom H. Effect of concurrent repair of medial meniscal posterior root tears
during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis. BMC musculoskeletal disorders, 2021; 22(1): 1-15.
Masuda S., Furumatsu T., Okazaki Y., Kodama Y. et al. Medial meniscus posterior root tear induces pathological
posterior extrusion of the meniscus in the kneeflexed position: An open magnetic resonance imaging analysis. Orthop Traumatol Surg Res. 2018; 104(4): 485-489.
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