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[目的]分析内侧半月板突出与膝关节自发性骨坏死的相关性,同时探讨内侧半月板后角根部撕裂(MMRT)对内侧半月板突出长度、骨坏死体积的影响。[方法]选取本院2011年1月~2014年12月诊断膝关节自发性骨坏死的17例患者,根据MRI上所测量的内侧半月板突出长度分为两组,突出长度≥3 mm者为半脱位组,<3mm则为对照组,对比两组间骨坏死体积;同时分析突出长度与骨坏死体积之间的相关性;根据MRI上是否存在内侧半月板后角根部撕裂,将患者分为撕裂组(MMRT组)和对照组,对比两组间内侧半月板突出长度以及骨坏死体积。[结果]17例患者中有16例(94.1%)存在不同程度的内侧半月板突出,其中9例(52.9%)为内侧半月板半脱位,半脱位组的骨坏死体积显著大于对照组(P=0.004),且内侧半月板突出长度与骨坏死体积之间呈正相关(r=0.845,P=0.000)。同时发现有7例(42.1%)患者伴有内侧半月板后角根部撕裂,撕裂组(MMRT组)的内侧半月板突出长度和骨坏死体积均大于对照组,但差异无统计学意义(P值分别为0.315、0.088)。[结论]内侧半月板突出和半脱位在膝关节自发性骨坏死患者中发生率高,而且突出长度与骨坏死体积呈正相关,这一现象支持膝关节自发性骨坏死病因学中的应力源性理论。导致严重内侧半月板突出的因素可能是多方面的,不仅仅是内侧半月板后角根部撕裂。
[Objective] To analyze the correlation between medial meniscus protrusion and spontaneous osteonecrosis of knee joint and to explore the effect of medial meniscus posterior horn root tear (MMRT) on medial meniscus protrusion length and osteonecrosis volume. [Methods] Twenty-seven patients diagnosed as spontaneous osteonecrosis of the knee joint from January 2011 to December 2014 in our hospital were divided into two groups according to the protrusion length of the medial meniscus measured on MRI. The length of protrusion ≥3 mm was Subluxation group, <3mm compared with the control group, compared the volume of osteonecrosis between the two groups; at the same time analysis of the relationship between the length of the prominent and the volume of osteonecrosis; according to MRI, there is medial meniscus posterior horn root tear, the patient points For the tear group (MMRT group) and control group, the medial meniscus protrusion length and the volume of osteonecrosis were compared between the two groups. [Results] Sixteen (94.1%) of the 17 patients had medial meniscus protrusion to some extent. Nine of them (52.9%) were medial meniscus subluxation, and the volume of osteonecrosis of the subluxation group was significantly larger than that of the control group = 0.004). There was a positive correlation between the length of medial meniscus and the volume of osteonecrosis (r = 0.845, P = 0.000). At the same time, 7 patients (42.1%) were found to have root tear in the posterior horn of the medial meniscus. The medial meniscus protrusion length and the volume of osteonecrosis in the tear group (MMRT group) were larger than those in the control group, but the difference was not statistically significant P values were 0.315,0.088, respectively). [Conclusions] The medial meniscus protrusion and subluxation are high in patients with spontaneous osteonecrosis of knee joint, and the length of protrusion is positively correlated with the volume of osteonecrosis. This phenomenon supports the stress source in the etiology of spontaneous osteonecrosis of the knee theory. Factors that cause severe medial meniscus may be multifaceted, not just at the posterior horn of the medial meniscus.