外侧半月板后根部损伤不同缝合位置对膝关节生物力学的影响

目的对损伤的外侧半月板后根部进行不同位置的修复固定,比较不同缝合方式时膝胫股关节的生物力学结果,探讨外侧半月板后根部损伤最佳缝合术式。方法使用8例人体尸体膝关节,胫腓骨固定装置维持膝关节在0°位,在1 k N压缩载荷下,采用Tek-scan压力感测片收集膝关节外侧半月板后根部完整、外侧半月板后根部断裂、将外侧半月板后根部分别缝合至中心点、中心点偏后5 mm、中心点偏前5 mm、中心点偏外5 mm位置下的平均接触压力、峰值压力以及接触面积。结果在外侧间室,与完整状态相比半月板后根部损伤断裂后会导致平均接触压力和峰值压力明显增加(P0. 01),接触面积减少(P0. 05)。4种缝合固定方法均可减少平均压力和峰值接触压力,接触面积较根部断裂时均有增加。在半月板后根部中心点偏外5 mm缝合时,生物力学结果更接近完整膝关节(P0. 05)。比较缝合位点在根部中心点和中心点偏后5 mm时,平均接触压力影响差别微小,峰值接触压力、接触面积均无统计学差异(P0. 05)。在内侧间室,生物力学指标各组间均无统计学差异(P0. 05)。结论外侧半月板后根部发生撕裂后会导致膝关节外侧间室的平均接触压力、峰值压力以及接触面积相比正常膝关节发生显著改变;半月板缝合位置在原根部中心点偏外5 mm时,其生物力学功能更接近完整膝关节。     

步态周期下半月板损伤对膝关节生物力学性能的影响

文题释义：半月板撕裂：膝关节内半月型纤维软骨破裂,撕裂原因主要是由于膝半屈或全屈位下的扭转力所造成。半月板分为内侧半月板和外侧半月板,内侧半月板较大且固定,外侧半月板较小,实验主要研究外侧半月板撕裂对力学机制的影响。 动态有限元分析：将人体正常完整步态周期作为边界条件施加在膝关节半月板模型中,观察在完整步态周期下半月板以及胫骨软骨的应力变化趋势及所受应力值大小。 背景：目前国内外对膝关节半月板的生物力学分析十分广泛,但大多集中于对膝关节屈曲运动状态下的研究,针对完整步态周期下膝关节半月板生物力学的有限元分析还不完善。 目的：通过对比外侧半月板撕裂模型与健康半月板模型,了解完整步态周期下半月板损伤后的生物力学变化机制。 方法：以健康成年人膝关节CT扫描数据为基础,建立包括胫-股骨、半月板、关节软骨在内的健康膝关节有限元模型,并在健康模型基础上进一步构建膝关节外侧半月板撕裂模型,探究在完整步态周期下膝关节外侧半月板撕裂的生物力学机制,并与健康膝模型进行对比。 结果与结论：①两种模型完整步态周期内的胫骨软骨瞬时应力变化趋势一致,但半月板撕裂模型中胫骨软骨在每一个瞬时受到的应力值均大于健康半月板模型,半月板撕裂模型与健康模型中胫骨软骨所受最大应力值分别为30,20.5 MPa;②两种模型完整步态周期内的半月板瞬时应力变化趋势是一致的,但撕裂模型中完整步态周期内半月板受到的应力均大于健康模型,半月板撕裂模型与健康模型中半月板所受最大应力值分别为69.8,41.3 MPa;③在步态周期的前60%,半月板撕裂模型中的胫骨软骨最大应力分布远大于健康模型,且随着步态周期的增长,接触范围逐渐向软骨外部边缘蔓延;在步态周期的60%以后,作用在胫骨软骨上的应力较小,最大应力的分布范围也比较小;④两种模型中健康内侧半月板应力分布基本一致,而撕裂的外侧半月板最大应力分布范围较健康内侧半月板广,在裂纹周围出现了较严重应力集中现象,且随着步态周期的进行,应力集中区域逐渐向裂纹靠近半月板前角处偏移;⑤结果表明半月板是人体膝关节中重要的承重部件,从生物力学角度可以较为直观地观察到半月板损伤对人体膝关节的危害。 ORCID: 0000-0002-2155-0058(吴铮) 中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

步态周期下内侧半月板后根部分撕裂对膝关节生物力学的影响

背景：目前针对内侧半月板后根撕裂加速膝关节退变相关生物力学研究大多数仅限于在静态仿真设计的基础上对内侧半月板后根完全撕裂模型进行测试,而对内侧半月板后根部分撕裂在完整步态周期下的生物力学行为尚不清楚。目的：运用动态有限元分析的方法来比较正常膝关节模型与内侧半月板后根部分撕裂模型在完整步态周期下生物力学的差异。方法：以健康成年人右膝关节CT扫描数据为基础,建立包括骨、半月板、关节软骨在内的健康膝关节有限元模型,并在健康模型基础上进一步构建膝关节内侧半月板后根撕裂模型。分别在2种模型上施加ISO标准步态载荷进行仿真测试。比较2种模型对应部件在各时相下应力、位移和接触面积的差异。结果与结论：(1)在完整步态周期下,健康模型内侧半月板后根云图应力分布均匀,而病理模型则在损伤区出现应力集中表现,健康模型最大应力出现在30%时刻外侧半月板内缘,值为29.68 MPa,病理模型最大应力出现在50%时刻外侧半月板内缘,值为30.34 MPa;(2)在完整步态周期下,健康和病理模型胫骨软骨应力分布大体一致,2种模型承受最大应力分别出现在步态周围50%,20%时刻,值大小分别为5.11,6.85MPa;(...     

同种异体半月板移植的研究进展

膝关节半月板具有重要的生物力学功能，它是维持膝关节正常生理功能的重要组成部分，它可以增加关节软骨面之间的接触面积，减小关节面单位面积上的压力，其楔形结构可增加膝关节的稳定性，缓冲纵向压力。半月板切除后必然导致韧带松驰，关节不稳，软骨面磨损加快，加速膝关节退行性改变，为了避免这些并发症的发生，     

轻度与重度骨关节炎膝关节的生物力学行为比较

目的 对比研究轻度与重度膝骨关节炎(knee osteoarthritis, KOA)膝关节的生物力学行为,阐述KOA进展的生物力学机制。方法 分别构建同一患者左侧轻度KOA(KL分级Ⅰ级)与右侧重度KOA(KL分级Ⅳ级)膝关节有限元模型。在材料属性、边界条件、载荷等设定相同的情况下进行有限元分析,比较轻度与重度KOA膝关节半月板、股骨软骨、胫骨软骨的接触面积、接触压及von Mises应力的变化特征。结果 重度KOA膝关节总接触面积和外侧室接触面积大于轻度KOA膝关节,而内侧间室接触面积小于轻度KOA膝关节。重度KOA膝关节半月板、股骨软骨和胫骨软骨上的接触压及von Mises应力峰值均大于轻度KOA膝关节;双膝关节外侧半月板上接触压及von Mises应力峰值均大于内侧半月板,双膝关节股骨软骨与胫骨软骨内侧间室接触压及von Mises应力峰值均大于外侧间室。结论 重度KOA膝关节应力分布不同于轻度KOA,接触面积、接触压和von Mises应力峰值的变化与半月板脱位、软骨缺损等因素相关,生物力学行为和解剖结构的改变促进了KOA进展。     

半月板的生物力学及其损伤修复的研究进展

临床工作中,在膝关节创伤时,经常会遇到半月板损伤。在现今,人们对半月板的生物力学功能进行许多研究（3-9）,越来越认识到半月板的生物力学功能重要性,认为不宜简单地将损伤半月板切除,而应修复它们,但半月板无血液供应区的损伤修复后不能愈合,这是骨科界的难题之一,为此人们亦进行了许多研究（10-16）。一. 半月板的大体形态、血液供应、显微镜下形态、生化等 半月板是介于股骨髁和胫骨平台之间的半月状软骨,其外侧缘较厚,内侧缘较薄,内侧半月板呈“c"形,外侧半月板近似呈“o"形。内侧半月板前角胫骨韧带止点附着于前交叉韧…     

早期创伤性膝骨关节炎动物模型构建方案的比较

背景：现有骨关节炎的有创造模方法包括前交叉韧带横断手术和前交叉韧带横断联合内侧半月板前角切除手术，前交叉韧带横断术后需要过量运动，而完整切除内侧半月板前角可能造成副损伤并增加造模结果的差异性，对术者手术技巧要求较高。目的：对传统的骨关节炎有创造模手段进行改良和简化，并比较不同方案在无高负荷运动环境下的造模效果。方法：采用随机数字表法将48只SD大鼠分为4组，每组12只：假手术组完全暴露左侧后肢膝关节腔后缝合关节腔及皮肤；横断组、横断+切除组、横断+撕裂组左侧后肢分别进行前交叉韧带横断手术、前交叉韧带横断联合内侧半月板前角切除手术、前交叉韧带横断联合内侧半月板前角撕裂手术。术后4周取膝关节标本，进行大体、X射线片、CT扫描、病理组织切片观察及PCR检测。结果与结论：(1)大体观察：横断组可见半月板处轻度磨损；横断+撕裂组可见外侧髁关节面严重磨损、内侧髁关节面轻度磨损、半月板严重磨损，内侧半月板全层磨损；横断+切除组可见外侧髁关节面严重磨损、内侧髁关节面轻度磨损、半月板内侧前角缺如，半月板磨损面积> 50%；(2)X射线片与CT扫描：4组无明显差异，其中3个手术组可见胫骨前移，横断+...     

内侧副韧带不同程度损伤时膝关节的应力变化

背景：膝关节内侧副韧带损伤易导致继发性的半月板及软骨损伤,长期慢性损害会引起骨关节炎的发生。目前,关于内侧副韧带断裂所致半月板及关节软骨损伤的力学研究较少。目的：探讨膝关节内侧副韧带不同程度损伤对膝关节半月板及软骨生物力学的影响。方法：选择一名健康志愿者行膝关节CT和MRI检查,获取其影像资料,将扫描数据依次导入Mimics、Geomagic及Solidworks软件,经配准融合后建立正常膝关节三维模型,并在此基础上模拟出膝关节内侧副韧带不同程度损伤的模型,共分为4组,包括：(1)内侧副韧带完整;(2)内侧副韧带深层断裂;(3)内侧副韧带浅层断裂;(4)内侧副韧带完全断裂。最后导入Ansys软件,对膝关节施加3种模式载荷：(1)股骨顶端施加10 N·m外翻力矩;(2)股骨顶端施加4 N·m内旋力矩;(3)股骨顶端施加4 N·m外旋力矩。分析4组模型在不同载荷下对膝关节生物力学的影响。结果与结论：(1)在膝关节伸直位,对膝关节施加10 N·m外翻力矩时,内侧副韧带不同程度损伤后外侧半月板总体应力均增加,关节软骨应力变化不明显,并且当内侧副韧带浅层出现断裂后外侧半月板应力峰值明显增大;(2...     

外侧支持带松解联合髌骨韧带重建修复复发性髌骨脱位

背景：关节镜检查能够直接动态观察髌股关节的对合关系,准确了解髌股关节异常是否可以完全纠正。目的：分析关节镜下外侧支持带松解联合髌骨韧带重建对复发性髌骨脱位的临床疗效。方法：复发性髌骨脱位患者共58例,随机将其分为对照组和观察组各29例,对照组患者给予常规手术行外侧支持带松解联合髌骨韧带重建,观察组患者给予关节镜下外侧支持带松解联合髌骨韧带重建。结果与结论：治疗前两组患者的Lysholm评分和Kujala评分的比较,差异均无显著性意义(P > 0.05);治疗12个月后两组患者的Lysholm评分和Kujala评分均升高,且观察组升高的更明显(P < 0.05)。治疗前两组患者屈膝30°时的适合角和外侧髌股角CT测量值的比较,差异均无显著性义(P > 0.05);治疗12个月后两组患者的适合角和外侧髌股角CT测量值均降低,且观察组降低的更明显(P < 0.05)。观察组患者的手术时间、临床愈合时间均显著低于对照组,总有效率显著高于对照组(P < 0.05)。结果表明关节镜下外侧支持带松解联合髌骨韧带重建修复复发性髌骨脱位疗效确切。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

胫骨外侧髁骨折塌陷对关节轴线及接触压力的影响

目的:研究在胫骨外侧髁骨折中关节面塌陷和外侧半月板切除对膝关节轴线、接触面积及压力的影响。方法:6个新鲜尸体膝关节标本制成胫骨外侧髁劈裂骨折模型,通过使用支撑垫片制成关节面塌陷0、1、2、4和6mm。膝关节在屈膝0°,负荷500N和屈膝30°,负荷350N。通过数码相机记录关节轴线的变化;而关节内外间隙的压力和压力扩散则由F-Scan感应器记录。每个标本在保留和切除外侧半月板下进行测试。结果:随着关节面塌陷高度的增加,膝关节外翻角度、外侧间隙的平均和最大的接触压力逐渐增加,而接触面积则逐渐减少。在屈膝0°,关节面塌陷6mm时,外翻角度平均增加7.6°,平均接触压力和最大接触压力分别增加208%和97%;而接触面积则减少33%。在同一关节面塌陷高度,切除半月板平均增加38%的外翻角度和外侧间隙45%的接触压力;而接触面积则减少26%。结论:研究结果表明在治疗胫骨外髁劈裂骨折中,减少关节面的塌陷十分重要,特别是在需切除半月板的时候。     

The Combined Effect of Frontal Plane Tibiofemoral Knee Angle and Meniscectomy on the Cartilage Contact Stresses and Strains

Abnormal tibiofemoral alignment can create loading conditions at the knee that may lead to the initiation and progression of knee osteoarthritis (OA). The degenerative changes of the articular cartilage may occur earlier and with greater severity in individuals with abnormal frontal plane tibiofemoral alignment who undergo a partial or total meniscectomy. In this investigation, subject specific 3D finite element knee models were created from magnetic resonance images of two female subjects to study the combined effect of frontal plane tibiofemoral alignment and total and partial meniscectomy on the stress and strain at the knee cartilage. Different amounts of medial and lateral meniscectomies were modeled and subject specific loading conditions were determined from motion analysis and force platform data during single-leg support. The results showed that the maximum stresses and strains occurred on the medial tibial cartilage after medial meniscectomy but a greater percentage change in the contact stresses and strains occurred in the lateral cartilage after lateral meniscectomy for both subjects due to the resultant greater load bearing role of the lateral meniscus. The results indicate that individual’s frontal plane knee alignment and their unique local force distribution between the cartilage and meniscus play an important role in the biomechanical effects of total and partial meniscectomy.     

Biomechanical analysis of the effects of medial meniscectomy on degenerative osteoarthritis

To investigate the effects of meniscectomy on degenerative osteoarthritis, a three-dimensional (3D) finite element (FE) model of the human lower limb is constructed from a combination of magnetic resonance (MR) images and computed tomographic (CT) images that can provide anatomically suitable boundary conditions for a knee joint. Four cases, i.e., the intact meniscus, and the partial, sub-total, and total meniscectomy of the medial meniscus are modeled and simulated. We consider that the cartilage-to-cartilage contact area and the peak contact pressure in the meniscus may be significant parameters in evaluating degenerative osteoarthritis. Partial meniscectomy can be regarded as a better treatment than sub-total/total meniscectomy, and a high possibility of degenerative osteoarthritis is anticipated after total meniscectomy. Moreover, medial meniscectomy has the potential to bring about degenerative osteoarthritis in both the medial compartment and the lateral compartment of a knee joint.     

The proximal attachments of the popliteus muscle: a quantitative study and clinical significance

Controversies about the existence of accessory proximal popliteus muscle attachments can be found in the literature. The aim of this study was to verify the occurrence and width of popliteus attachments on the articular and periarticular structures of the knee joint. The relation of these attachments to tibiofemoral cartilage and meniscus degeneration was also investigated. Forty-two anatomical specimens were dissected. The incidence of accessory proximal attachments was determined and their width measured using a caliper. The fibular attachment of the popliteus was observed in 98% of cases; its mean width was 11 (SD 3) mm. At least one attachment on the lateral meniscus was found in 95% of the specimens, with a mean width of 6 (SD 2) mm. Three types of meniscal attachments of the popliteus could be identified. The severity of meniscus and tibiofemoral cartilage alterations was significantly related to the number of meniscopopliteal fascicles: more severe alterations were seen in knees with fewer meniscopopliteal fascicles. Popliteus attachments on the posterior knee joint capsule (57%), arcuate (90%) and oblique popliteal (79%) ligaments were also observed in most specimens. Popliteus muscle relationships with the posterior cruciate (5%) and meniscofemoral (33%) ligament were less common. In conclusion, accessory popliteus attachments on the fibula, lateral meniscus and arcuate popliteal ligament can be considered constant characteristics. The results of this study suggest a role of the popliteus in the protection of knee menisci and tibiofemoral cartilage.     

石家庄市部分青年男性“外八字”步态足底压力特征分析

背景：外八字的脚外翻破坏了膝关节正常力的分布,使关节一侧所受的生物应力增大,对侧相对减少。 目的：更进一步认识“外八字”步态行走过程中足底压力的特征。 方法：运用比利时Footscan足底压力分布测试系统对石家庄市部分20~25岁的青年男性进行足底压力测试,通过分析筛选出双足步态均正常的青年男性39人为正常步态组,筛选出双足步态均为外八字的青年男性39人为异常步态组分别进行分析。 结果与结论：异常步态组青年左足足底第3跖骨峰力值明显高于正常步态组(P < 0.01),第5跖骨、足弓两区域骨峰力值明显低于正常步态组(P < 0.05)。正常步态组青年左、右足足底第1跖骨、第5跖骨两区域冲量差异有显著性意义(P < 0.05)。异常步态组青年左、右足足底第2,4跖骨冲量差异有显著性意义(P < 0.01,P < 0.05)。异常步态组与正常步态组青年左足足底第3跖骨区域差异有显著性意义(P < 0.05),足跟内侧、足跟外侧两区域冲量差异有非常显著性意义(P < 0.01);右足足底足跟内侧区域冲量比较差异有非常显著性意义(P < 0.01)。提示“外八字”行走会导致蹬伸时的推进力不是斜向向前,行走方向上的蹬地力较小;行走过程中足受力顺序不是沿足纵弓的方向,而是有一定的夹角,因此足弓不能起到减震的作用,冲量的增大也就增加损伤的概率。所以“外八字”步态者应当注意足底压力和作用时间的关系,增加足与地面的接触时间,从而减小冲击力值,避免运动损伤。     

Regeneration of whole meniscus using meniscal cells and polymer scaffolds in a rabbit total meniscectomy model

The current treatments of meniscal lesion in knee joint are not perfect to prevent adverse effects of meniscus injury. Tissue engineering of meniscus using meniscal cells and polymer scaffolds could be an alternative option to treat meniscus injury. This study reports on the regeneration of whole medial meniscus in a rabbit total meniscectomy model using the tissue engineering technique. Biodegradable scaffolds in a meniscal shape were fabricated from polyglycolic acid (PGA) fiber meshes that were mechanically reinforced by bonding PGA fibers at cross points with 75:25 poly(lactic-co-glycolic acid). The compressive modulus of the bonded PGA scaffold was 28-fold higher than that of nonbonded scaffold. Allogeneic meniscal cells were isolated from rabbit meniscus biopsy and cultured in vitro. The expanded meniscal cells were seeded onto the polymer scaffolds, cultured in vitro for 1 week, and transplanted to rabbit knee joints from which medial menisci were removed. Ten or 36 weeks after transplantation, the implants formed neomenisci with the original scaffold shape maintained approximately. Hematoxylin and eosin staining of the sections of the neomenisci at 6 and 10 weeks revealed the regeneration of fibrocartilage. Safranin-O staining showed that abundant proteoglycan was present in the neomenisci at 10 weeks. Masson's trichrome staining indicated the presence of collagen. Immunohistochemical analysis showed that the presence of type I and II collagen in neomenisci at 10 weeks was similar to that of normal meniscal tissue. Biochemical and biomechanical analyses of the tissue-engineered menisci at 36 weeks were performed to determine the quality of the tissue-engineered menisci. Tissue-engineered meniscus showed differences in collagen content and aggregate modulus in comparison with native meniscus. This study demonstrates, for the first time, the feasibility of regenerating whole meniscal cartilage in a rabbit total meniscectomy model using the tissue engineering method.     

Regeneration of whole meniscus using meniscal cells and polymer scaffolds in a rabbit total meniscectomy model

The current treatments of meniscal lesion in knee joint are not perfect to prevent adverse effects of meniscus injury. Tissue engineering of meniscus using meniscal cells and polymer scaffolds could be an alternative option to treat meniscus injury. This study reports on the regeneration of whole medial meniscus in a rabbit total meniscectomy model using the tissue engineering technique. Biodegradable scaffolds in a meniscal shape were fabricated from polyglycolic acid (PGA) fiber meshes that were mechanically reinforced by bonding PGA fibers at cross points with 75:25 poly(lactic-co-glycolic acid). The compressive modulus of the bonded PGA scaffold was 28-fold higher than that of nonbonded scaffold. Allogeneic meniscal cells were isolated from rabbit meniscus biopsy and cultured in vitro. The expanded meniscal cells were seeded onto the polymer scaffolds, cultured in vitro for 1 week, and transplanted to rabbit knee joints from which medial menisci were removed. Ten or 36 weeks after transplantation, the implants formed neomenisci with the original scaffold shape maintained approximately. Hematoxylin and eosin staining of the sections of the neomenisci at 6 and 10 weeks revealed the regeneration of fibrocartilage. Safranin-O staining showed that abundant proteoglycan was present in the neomenisci at 10 weeks. Masson's trichrome staining indicated the presence of collagen. Immunohistochemical analysis showed that the presence of type I and II collagen in neomenisci at 10 weeks was similar to that of normal meniscal tissue. Biochemical and biomechanical analyses of the tissue-engineered menisci at 36 weeks were performed to determine the quality of the tissue-engineered menisci. Tissue-engineered meniscus showed differences in collagen content and aggregate modulus in comparison with native meniscus. This study demonstrates, for the first time, the feasibility of regenerating whole meniscal cartilage in a rabbit total meniscectomy model using the tissue engineering method.     

A Hydrogel Meniscal Replacement: Knee Joint Pressure and Distribution in an Ovine Model Compared to Native Tissue

Pressure distribution of the native ovine knee meniscus was compared to a medial meniscectomy and three treatment conditions including a suture reattachment of the native tissue, an allograft, and a novel thermoplastic elastomer hydrogel (TPE) construct. The objective of this study was to assess the efficacy of a novel TPE hydrogel construct at restoring joint pressure and distribution. Limbs were loaded in uniaxial compression at 45°, 60°, and 75° flexion and from 0 to 181 kg. The medial meniscectomy decreased contact area by approximately 50% and doubled the mean and maximum pressure reading for the medial hemijoint. No treatment condition tested within this study was able to fully restore medial joint contact area and pressures to the native condition. A decrease in lateral contact area and increase in pressures with the meniscectomy was also seen; and to some degree, all reattachment and replacement conditions including the novel TPE hydrogel replacement helped to restore lateral pressures. Although the TPE construct did not perform as well as hoped in the medial compartment, it performed as well as, if not better, than the other reattachment and replacement options in the lateral. Further work is necessary to determine the best anchoring and attachment methods.     

Meniscal ossicle: a case report

Meniscal ossicle is a cortical or cancellous tissue with central viable marrow surrounded by meniscal cartilage. We present a case of medial meniscal ossicle at its posterior horn. A 21-year-old male military recruit visited our clinic due to left knee discomfort. He had not undergone any notable injury on the knee, but complained of intermittent catching or giving way without locking. Simple radiographs showed a small round bony fragment at posteromedial side of knee joint. The magnetic resonance imaging revealed an intra-substance lesion of meniscus, whose signal is identical to bone. On arthroscopy, the articular cartilage of medial femoral condyle and tibial plateau appeared degenerative with a groove-like scar. The medial meniscus seemed swollen at the posterior horn, but there was no discernible tear in the adjacent meniscus. After piecemeal removal of meniscal substance, a small osseous fragment was identified, which was evacuated via posteromedial portal. The resection of meniscus amounted to a subtotal meniscectomy. The activities of daily living were possible without any trouble even after 9 months of follow-up. This entity should be distinguished from intra-articular loose body, and included in the differential diagnosis of the incidental findings of small ossified density around knee joint.     

膝关节半月板根部MRI影像解剖

目的 总结半月板根部的MRI解剖特点,确定半月板主体部分与根部的分界。方法 收集2012年10月—2014年2月保定市第一中心医院骨科24例经关节镜证实正常半月板根部的膝关节MRI资料和1例男性成人患者因下肢动脉硬化而截肢的新鲜膝关节标本,对半月板根部的MRI解剖行前瞻性研究,总结半月板根部MRI的形态、走行及附着点的位置,分析信号特点,并测量根部的长度、宽度、高度以及各根部走行角度。另在新鲜膝关节标本上确定半月板主体部分与根部的分界并用铜丝标示之,对标本行MRI扫描。结果 24例患者膝关节MRI显示:内侧半月板后根部呈梳状斜向下走行,信号较半月板主体部分稍高,附着于髁间后区;外侧半月板后根部较内侧半月板后根部明显长,走行于髁间隆起,附着于内侧髁间隆起的外侧面,信号与半月板主体部分类似;内侧半月板前根部较细,附着于髁间前区最前缘,为低或较低信号;外侧半月板前根部呈梳状稍向下向后走行,信号稍高,附着于髁间前区并稍向外下方倾斜的骨表面。各根部测量数据显示:横断面外侧半月板后根部最长,为(15.74±2.03)mm;冠状面内侧半月板后根部最短,为(7.88±1.57)mm;外侧半月板后根部走行与标准冠状面扫描线的夹角角度最大,为34.00°±9.24°。1例新鲜标本MR扫描图片清晰,半月板主体部分与根部分界标记显示清晰。结论 内外侧半月板前后根部各有其特点,MRI能够清晰显示半月板根部的形态、走行、信号特点及附着点位置。