Introduction: Internal derangement of the knee is a blanket term used to cover a group of disorders involving destruction of the normal functioning of the ligaments or cartilages. MRI provides excellent soft tissue co...Introduction: Internal derangement of the knee is a blanket term used to cover a group of disorders involving destruction of the normal functioning of the ligaments or cartilages. MRI provides excellent soft tissue contrast and is capable of evaluating the soft tissue and bony structures in multiple imaging planes which provide significant advantage in IDK. Methods and Materials: A prospective study of hundred twenty patients who underwent MRI for the diagnosis of internal derangement of knee between the period January 2013 and January 2015 was conducted. All the patients gave a history of knee joint pain following trauma and clinically suspected to have meniscal and ligament tears. Patients were evaluated using Philips intera R 11 1.5 T with pulsar gradient system using a sensor extremity coil. Results: Commonest lesion detected in our study was ACL tear followed by meniscal tear and medial collateral ligament injury. The most common sign of cruciate ligament injury was hyper intensity in the ligament. Grade 3 was the most common grade of meniscal tear. Conclusion: MRI is unique in its ability to evaluate the internal structure as well as the surface of the meniscus. Many anatomical variants can mimic a tear on MRI. MRI is an excellent non invasive modality for imaging the knee.展开更多
目的探讨急性膝关节多发韧带损伤时十字韧带与周围韧带损伤的不同特点及早期手术的疗效,提出治疗观点.方法选择1999年8月～2002年6月经手术治疗的47例累及两组以上膝关节韧带损伤的病例,其中随访1年以上者40例,男28例,女12例;年龄22～50...目的探讨急性膝关节多发韧带损伤时十字韧带与周围韧带损伤的不同特点及早期手术的疗效,提出治疗观点.方法选择1999年8月～2002年6月经手术治疗的47例累及两组以上膝关节韧带损伤的病例,其中随访1年以上者40例,男28例,女12例;年龄22～50岁,平均33.5岁.所有病例均行关节镜下前、后十字韧带重建和(或)周围侧副韧带修补.结果IKDC评分,正常10例,接近正常25例,不正常5例.Lysholm评分:优30例,良8例,中2例.膝关节活动度:伸膝完全正常者35例,轻度受限者5例,但均小于10°.膝关节屈曲活动度:完全正常者26例,受限10°以内者10例,受限20°以内者3例,受限30°者1例.膝关节稳定性检查:28例前十字韧带手术患者中Lachman(-)16例,(+)12例;轴移试验(-)20例,(+)8例;KT-1000关节活动度＜3 mm 23例,3～5 mm 5例.22例后十字韧带手术患者中PDT(-)5例,(+)16例,(++)1例;KT-1000关节活动度＜3 mm 5例,3～5 mm11例,5～7 mm 5例,7～10 mm 1例.25例内侧副韧带手术患者中Abd 0°(-)16例,(+)9例;Abd 30°(+)10例,(+)13例,(++)2例.14例后外复合体手术患者中Add0°(-)3例,(+)10例,(++)1例;Add 30°(-)2例,(+)11例,(++)1例,其中(++)者视为失效.结论膝关节多发韧带损伤的关键是早期治疗,后外复合体及Ⅲ度周围韧带损伤应早期手术修补.后十字韧带自愈能力强,应选择Ⅱ度以上者进行手术,前、后十字韧带最好同期重建,如果条件不具备,可优先选择重建后十字韧带,术后应注意被动伸膝及CPM功能锻炼.展开更多
文摘Introduction: Internal derangement of the knee is a blanket term used to cover a group of disorders involving destruction of the normal functioning of the ligaments or cartilages. MRI provides excellent soft tissue contrast and is capable of evaluating the soft tissue and bony structures in multiple imaging planes which provide significant advantage in IDK. Methods and Materials: A prospective study of hundred twenty patients who underwent MRI for the diagnosis of internal derangement of knee between the period January 2013 and January 2015 was conducted. All the patients gave a history of knee joint pain following trauma and clinically suspected to have meniscal and ligament tears. Patients were evaluated using Philips intera R 11 1.5 T with pulsar gradient system using a sensor extremity coil. Results: Commonest lesion detected in our study was ACL tear followed by meniscal tear and medial collateral ligament injury. The most common sign of cruciate ligament injury was hyper intensity in the ligament. Grade 3 was the most common grade of meniscal tear. Conclusion: MRI is unique in its ability to evaluate the internal structure as well as the surface of the meniscus. Many anatomical variants can mimic a tear on MRI. MRI is an excellent non invasive modality for imaging the knee.
文摘目的探讨急性膝关节多发韧带损伤时十字韧带与周围韧带损伤的不同特点及早期手术的疗效,提出治疗观点.方法选择1999年8月～2002年6月经手术治疗的47例累及两组以上膝关节韧带损伤的病例,其中随访1年以上者40例,男28例,女12例;年龄22～50岁,平均33.5岁.所有病例均行关节镜下前、后十字韧带重建和(或)周围侧副韧带修补.结果IKDC评分,正常10例,接近正常25例,不正常5例.Lysholm评分:优30例,良8例,中2例.膝关节活动度:伸膝完全正常者35例,轻度受限者5例,但均小于10°.膝关节屈曲活动度:完全正常者26例,受限10°以内者10例,受限20°以内者3例,受限30°者1例.膝关节稳定性检查:28例前十字韧带手术患者中Lachman(-)16例,(+)12例;轴移试验(-)20例,(+)8例;KT-1000关节活动度＜3 mm 23例,3～5 mm 5例.22例后十字韧带手术患者中PDT(-)5例,(+)16例,(++)1例;KT-1000关节活动度＜3 mm 5例,3～5 mm11例,5～7 mm 5例,7～10 mm 1例.25例内侧副韧带手术患者中Abd 0°(-)16例,(+)9例;Abd 30°(+)10例,(+)13例,(++)2例.14例后外复合体手术患者中Add0°(-)3例,(+)10例,(++)1例;Add 30°(-)2例,(+)11例,(++)1例,其中(++)者视为失效.结论膝关节多发韧带损伤的关键是早期治疗,后外复合体及Ⅲ度周围韧带损伤应早期手术修补.后十字韧带自愈能力强,应选择Ⅱ度以上者进行手术,前、后十字韧带最好同期重建,如果条件不具备,可优先选择重建后十字韧带,术后应注意被动伸膝及CPM功能锻炼.
