Menisküs yırtıkları ile medial patellofemoral rüptür arasındaki ilişkinin tedavi yöntemi ve cinsiyete göre analizi

Year 2023, , 206 - 212, 30.06.2023

Ayşe Gül Kabakcı , Volkan Tolga Tekbaş , Memduha Gülhal Bozkır

https://doi.org/10.53446/actamednicomedia.1192308

Abstract

Amaç: Bu çalışmanın amacı, medial patellofemoral ligament rüptürü olan hastalarda patellar yükseklik, uyum açısı, lateral patellofemoral açı parametrelerinin tedavi yöntemine (cerrahi veya konvansiyonel), cinsiyete ve lateral ve medial menisküs yırtıkları olup olmamasına göre detaylı anatomik analizini yapmaktır.
Gereç ve Yöntem: Bu çalışma Ocak 2010 ile Ocak 2021 tarihleri arasında retrospektif olarak planlandı. Analiz için 61dize ait(61 kişi) manyetik rezonans görüntüleri (MRG) alındı. Bunlardan 38 diz sol ve 23 diz ise sağ tarafa aitti. Bir orthopedist ve iki anatomist, patellar morfolojiyi, patellar yüksekliği ve patellar hizalamayı bağımsız olarak ölçtü ve lateral, medial menisküs yırtıklarını değerlendirdi. Aksiyel T2 ağırlıklı turbo spin eko (TR:3600, TE:87 ms; kesit kalınlığı 5 mm; boşluk 1.5 mm) içeren diz MRG protokolü kullanıldı.
Bulgular: Konvansiyonel ve cerrahi tedavi grupları arasında yaş parametresi hariç (cerrahi tedavi yapılanlarda; 27,06±6,20 ve konvansiyonel tedavi yapılanlarda; 27,47±5,33), patellar yükseklik (cerrahi tedavi yapılanlarda; 1.21±0.27 ve konvansiyonel tedavi yapılanlarda; 0.99±0.16), uyum açısı (cerrahi tedavi yapılanlarda; -4.94±4.72 ve konvansiyonel tedavi yapılanlarda; 4.93±5.72), lateral patellofemoral açı (cerrahi tedavi yapılanlarda; -35.61 ve konvansiyonel tedavi yapılanlarda; 10,93±15,00) arasında anlamlı fark bulundu (p<0,05). Ayrıca medial patellofemoral yırtığı olan hastaların 29'unda lateral menisküs yırtığı, 11'inde medial menisküs yırtığı ve 8'inde hem lateral hem de medial menisküs yırtığı tespit ettik.
Sonuç: Menisküs yırtıkları ile medial patellofemoral rüptür arasındaki ilişkinin tedavi sürecini etkileyeceğini bulduk. Ayrıca bu çalışma, medial patellofemoral rüptürü olan hastalarda radyolojik ve klinik korelasyonların, patello-femoral pozisyonların değerlendirilmesine katkıda bulunacaktır.

Keywords

anatomi, uyum açısı, lateral patellofemoral açı, diz, menisküs yırtıkları, patellar yükseklik

Analysis of the relationship between meniscal tears and medial patellofemoral rupture according to the treatment method and gender

Abstract

Objective: The aim of this study was to make a detailed anatomical analysis of the parameters of patellar height, the congruence angle, the lateral patellofemoral angle in patients with medial patellofemoral rupture, according to the treatment method (surgical or conventional), gender and whether or not there is a lateral and medial meniscus tears.
Methods: This study was planned as retrospective study between January 2010 and January 2021. Magnetic resonance images (MRI) of 61 knees (61 individuals) were obtained for analysis. Of those, 38 knees were left, and 23 were right. One orthopaedic surgeons and two anatomist independently measured patellar morphology, patellar height and patellar alignment and evaluation lateral and medial meniscus tears. Knee MRI protocol including axial T2-weighted turbo spin echo (TR:3600, TE:87 ms; slice thickness 5 mm; gap 1.5 mm) was used.
Results: There was a significant difference patellar height (surgery; 1.21±0.27 and conventional; 0.99±0.16), the congruence angle (surgery; -4.94±4.72 and conventional; 4.93±5.72), the lateral patellofemoral angle (surgery; -35.61±16.62 and conventional; 10.93±15.00), except for age parameter (surgery; 27.06±6.20 and conventional; 27.47±5.33) between the conventional and surgical treatment groups (p<0.05). Moreover, we found that 29 patients of the patients with medial patellofemoral rupture had a lateral meniscus tear, 11 patients had a medial meniscus tear, and 8 patients had both lateral and medial meniscus tears.
Conclusion: We found that relationship between meniscal tears and medial patellofemoral rupture will affect the treatment course. Also, this study will contribute to evaluate the radiological and clinical correlations, patello-femoral positioning in patients who medial patellofemoral rupture.

Keywords

anatomy, congruence angle, lateral patellofemoral angle, knee, meniscus tears, patellar height

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