HALUK ÖZCANLI, Ahmet T. AYDIN, Asım KAYAALP, Yaman SARPEL, İsmet TAN

Anterior intermeniskal ligamentin artroskopik değerlendirilmesi

Amaç: Bu çalışmada anterior intermeniskal ligamentin görülme sıklığı artroskopik olarak araştırıldı ve anatomik özellikleri (kalınlık ve menisküs ön boynuzuna yapışma tipleri) ve travmatik olmayan diz içi patolojilerle ilişkisi değerlendirildi. Çalışma planı: Çok merkezli olarak planlanan bu çalışmada kayıtları tam olan 136 hastanın (80 erkek, 56 kadın; ort. yaş 40; dağılım 15-74) dizinde artroskopik değerlendirme sırasında anterior intermeniskal ligament araştırıldı. Bağın artroskopik özellikleri prob ile belirlendi. Sonuçlar: Seksen olguda (%58.8) anterior intermeniskal ligament belirlendi. Bu olguların 33'ü kadın (%58.9), 47'si erkek (%58.8) idi (p>0.05). Ligament 19 olguda (%14) belirgin kord benzeri yapıda idi. Altmış bir olguda (%44.9) membran şeklinde izlenen ligament, bu olgularin 34'ünde (%55.7) sinovyal abrazyon sonrası gözlenebildi. Anterior intermeniskal ligamentin yapışma özellikleri, Nelson ve LaPrade'nin tanımladığı şekilde değerlendirildi. Buna göre 47 olguda tip A (%58.8), 23 olguda tip B (%28.8), 10 olguda tip C (%12.5) saptandı. Kord tipi intermeniskal ligament bulunan olgularda tip A daha sık gözlenmekle birlikte, bu durum istatistiksel olarak bir anlamı bulunamadı (p>0.05). Ligament ile diz içi patolojiler arasında anlamlı bir ilişki saptanmadı. Diskoid lateral menisküs ile kord şeklinde intermeniskal ligamentin birlikte bulunması anlamlı bulundu (p

Anahtar Kelimeler:

Kıkırdak, eklem, Diz yaralanmaları, Menisküs, tibial, Artroskopi, Diz eklemi, Ön çapraz bağ

An arthroscopic study on the anterior intermeniscal ligament

Objectives: An arthroscopic study was made on the presence and anatomic features of the anterior intermeniscal ligament with regard to its thickness and attachment patterns to the anterior horn of the menisci, together with its relationship with associated non-traumatic intraarticular disorders of the knee. Methods: This multicenter study included 136 consecutive patients (80 males, 56 females; mean age 40 years; range 15 to 74 years) in whom the presence of anterior intermeniscal ligament was sought during arthroscopic examination of the knee. Arthroscopic features of the ligament was evaluated by probe. Results: The anterior intermeniscal ligament was detected in 80 knees (58.8%). Its presence did not differ significantly with respect to sex (33 females, 58.9%; 47 males, 58.8%; p>0.05). A cord-like appearance was observed in 19 cases (14%), whereas a membranous-like structure was identified in 61 cases (44.9%), 34 (55.7%) of which could only be detected following synovial abrasion. Attachment patterns according to the Nelson and LaPrade's description showed type A in 47 cases (58.8%), type B in 23 cases (28.8%), and type C in 10 cases (12.5%). Type A was more common among cord-like intermeniscal ligaments, although this did not reach significance (p>0.05). No significant association was found between the presence of the ligament and intraarticular disorders. The detection of discoid lateral meniscus was significantly associated with the presence of a cord-like intermeniscal ligament (p<0.05). Of eight cases with discoid lateral meniscus (5 complete, 3 incomplete), five patients exhibited a cord-like anterior intermeniscal ligament. Conclusion: This is the first arthroscopic study to define the anatomy and the incidence of the anterior intermenis-cal ligament. Functional features of the ligament should be more clearly demonstrated biomechanically.

Keywords:

Cartilage, Articular, Knee Injuries, Menisci, Tibial, Arthroscopy, Knee Joint, Anterior Cruciate Ligament,

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