Background:

Determining the rotational axis of the bony trough during lateral meniscal allograft transplant (MAT) is difficult. The use of anatomic landmarks may help a surgeon determine the rotational alignment of the graft during the procedure.

Purpose:

To investigate the association between the knee's anatomic landmarks and the position of the bony trough to prevent extrusion after lateral MAT.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Enrolled were 44 patients who underwent lateral MAT between July 2000 and February 2011. The patients’ mean age at the time of surgery was 30.8 years. Extrusion was measured on magnetic resonance imaging (MRI) scans at a mean of 3.6 months postoperatively, and patients were divided into an extrusion group (n = 15) and a no-extrusion group (n = 29). Three coronal MRI scans from each patient were selected, each from the region at the level of the tibial tuberosity (TT), the anterior bony trough, and the posterior bony trough. We measured the distance between the center of the anterior bony trough and the center of the TT (the TT distance) and the distance between the center of the posterior bony trough and the medial border of the lateral femoral condyle (LFC) (the LFC distance).

Results:

The mean center of the anterior bony trough was in a more medial position relative to the center of the TT in the no-extrusion group (–2.9 ± 4.8 mm) compared with the extrusion group (1.3 ± 4.9 mm; P = .010). The mean center of the posterior bony trough was in a more medial position relative to the medial border of the LFC in the no-extrusion group (–1.7 ± 3.9 mm) compared with the extrusion group (1.0 ± 3.2 mm; P = .027). Both TT distance and LFC distance were significantly correlated with extrusion (P = .005 and .025, respectively). The cutoff value was –0.24 mm for the anterior bony trough and –0.58 mm for the posterior bony trough (negative values indicate that the trough was medial to the respective landmarks).

Conclusion:

To prevent extrusion of the allograft, the center of the anterior bony trough needs to be aligned with the center of the TT, and the center of the posterior bony trough needs to be aligned with the medial border of the LFC.

中文翻译：

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外侧半月板同种异体移植解剖标志与骨槽位置的相关性

背景：

在外侧半月板同种异体移植 (MAT) 期间确定骨槽的旋转轴是困难的。解剖标志的使用可以帮助外科医生在手术过程中确定移植物的旋转对齐。

目的：

研究膝关节解剖标志与骨槽位置之间的关联，以防止侧垫后挤压。

学习规划：

横断面研究；证据水平，3。

方法：

入组的 44 名患者在 2000 年 7 月至 2011 年 2 月期间接受了横向 MAT。手术时患者的平均年龄为 30.8 岁。术后平均 3.6 个月通过磁共振成像 (MRI) 扫描测量挤压，并将患者分为挤压组 (n = 15) 和非挤压组 (n = 29)。选择了每位患者的三个冠状 MRI 扫描，每个扫描来自胫骨结节 (TT)、前骨槽和后骨槽水平的区域。我们测量了前骨槽中心与 TT 中心之间的距离（TT 距离）和后骨槽中心与股骨外侧髁（LFC）内侧缘之间的距离（LFC 距离） ）。

结果：

与挤压组 (1.3 ± 4.9 mm; P = .010)相比，非挤压组 (–2.9 ± 4.8 mm) 前骨槽的平均中心位于相对于 TT 中心更靠内侧的位置. 与挤压组 (1.0 ± 3.2 mm) 相比，非挤压组 (–1.7 ± 3.9 mm) 后骨槽的平均中心相对于 LFC 的内侧边界处于更内侧的位置 (1.0 ± 3.2 mm; P = .027 ）。TT 距离和 LFC 距离都与挤压显着相关（分别为P = .005 和 0.025）。前骨槽的截断值为–0.24 mm，后骨槽的截断值为–0.58 mm（负值表示槽位于相应标志的内侧）。

结论：

为了防止异体移植物的挤压，前骨槽的中心需要与 TT 的中心对齐，后骨槽的中心需要与 LFC 的内侧边缘对齐。