2023, Vol. 27 ›› Issue (5): 663-668

Anatomic risk factors for medial meniscus posterior root tears combined with anterior cruciate ligament injuries

Liu Guangluan1, Guo Zonglei1, Ge Jin1, Huang Dong1, Wang Yehua1, 2   

Abstract: BACKGROUND: Numerous studies have shown that the increased posterior inclination of the tibial plateau is an important risk factor for anterior cruciate ligament injury, which may promote the occurrence of medial meniscus posterior root tear. However, there are few studies on the anatomical risk factors of meniscus injury.
OBJECTIVE: To compare the anatomic risk factors for medial meniscus posterior root tear at the proximal tibia in the case of anterior cruciate ligament injury and to improve the vigilance of clinicians to specific patients with anterior cruciate ligament injury.
METHODS: Clinical data of 107 patients with anterior cruciate ligament injury who were admitted to the Department of Orthopedics of Xuzhou Medical University Hospital from January 2018 to December 2021 were retrospectively analyzed. They were divided into two groups according to whether there was medial meniscus posterior root tear confirmed by clinical and imaging diagnosis. Fifty-one patients with anterior cruciate ligament injury combined with medial meniscus posterior root tear were included in observation group, while fifty-six patients with simple anterior cruciate ligament injury were included in control group. Preoperative MRI was used to measure the medial and lateral posterior tibial slope (MPTS, LPTS), the medial and lateral posterior meniscal slope (MMS, LMS), the difference between the MPTS and LPTS (Δ-TS) and between the MMS and LMS (Δ-MS), and the medial tibial plateau depth (MTPD) of the two groups in a blind way.
RESULTS AND CONCLUSION: There was no significant difference between the two groups in LPTS, LMS, Δ-TS, and MTPD (P > 0.05). The MTPS, MMS and Δ-MS in the observation group were significantly higher than those in the control group (P < 0.05). Multivariate Logistic regression analysis showed that the MPTS was an independent risk factor for anterior cruciate ligament injury with medial meniscus posterior root tear (P < 0.05). Receiver operating characteristic curve showed that the MPTS had a certain predictive value for anterior cruciate ligament injury with medial meniscus posterior root tear. All the results indicate that increased MPTS, increased MMS, and increased asymmetry of Δ-MS are important risk factors for anterior cruciate ligament injury with medial meniscus posterior root tear. This study provides important information for the diagnosis of medial meniscus posterior root tear, thus avoiding missed diagnosis and providing a theoretical basis for early ligament repair to reduce the risk of meniscus tear in clinical practice.
Key words: anterior cruciate ligament injury, medial meniscus posterior root tear, magnetic resonance imaging, anatomic risk factors, medial posterior tibial slope, medial posterior meniscal slope, posterior tibial delta-slope, medial tibial plateau depth