MEDİAL MENİSKAL EKSTRÜZYON İLE DEJENERATİF ARTRİTİN NEDEN SONUÇ İLİŞKİSİ BAKIMINDAN İNCELENMESİ Investigation of the Cause-Effect Relationship Between Degenerative Arthritis and Medial Meniscal Extrusion

Year 2020, Volume: 10 Issue: 2, 16 - 22, 08.06.2020

Nilüfer Aylanç Şenay Bengin Ertem

Abstract

ÖZET
Amaç: Diz ekleminde önemli bir biyomekanik etkiye sahip olan menisküsün yapısal bozukluklar ile, erişkin
bireylerde sık rastlanan osteoartrit süreci ile olan ilişkisinin neden-sonuç ilişkisi bakımından irdelemek.
Yöntem: 46 kadın ve 48 erkekten oluşan hastalara ait 94 diz MR tetkiki retrospektif olarak gözden geçirildi.
Bu olgularda medial meniskal yer değişiklikleri-ekstrüzyonlar ve aynı zamanda MR görüntülerde tibiofemoral
kartilaj kalınlıkları, eklem mesafeleri ve medial menisküsü destekleyen temel ligamanlardan olan MCL’nin
durumu ya da hasar dereceleri değerlendirildi ve bulgular karşılaştırıldı.
Bulgular: Yaş ortalaması 47,9±12,7 olan 46 kadın ve 48 erkek hastaya ait toplamda 94 diz MR değerlendirildi.
Olguların yaş ortalamaları arttıkça medial eklem aralığı ve medial menisküs ekstrüzyon (MME) derecesi arasında
anlamlı korelasyon saptandı. Medial eklem mesafesi ile medial ve lateral kartilaj kalınlıkları arasında
ve lateral eklem aralığı arasında pozitif korelasyon saptandı. Medial menisküs hasar derecesi arttıkça medial
kartilaj kalınlıkları azalırken MME derecesi artmakta idi. Ayrıca lateral kartilaj kalınlıkları ile lateral meniskal
ekstrüzyon (LME) derecesi arasında negatif korelasyon saptandı. MCL hasar derecelerine göre gruplar arasında
medial ekstrüzyon (MME) açısından istatistiksel olarak anlamlı fark saptandı (p<0,001).
Sonuç: Meniskal ekstrüzyon yaş ile artan dejeneratif süreçlerin de birlikteliğinde oldukça sık görülmektedir.
Meniskal ekstrüzyon oranı, MCL gibi komşu ligaman hasarlarında da artmaktadır. Gerek osteoartrit gerek
meniskopati ve gerekse ligaman hasarları bir arada görülebilmekle birlikte meniskal ekstrüzyon, kartilaj hasarını
kolaylaştırdığından dejeneratif artrit gelişiminin nedenlerinden sayılabilir.
Anahtar sözcükler: Manyetik rezonans görüntüleme; Menisküsler; Medial; Menisküsler; Lateral; Osteoartrit;
Diz; ligamentler.
ABSTRACT
Objective: The aim of this study was to investigate the relationship between the structural disorders of the
meniscus with a significant biomechanical effect in the knee joint with the common osteoarthritis process
in adult subjects.
Methods: Knee MRI images of 94 females and 48 males were retrospectively evaluated in this study. In
these cases, medial meniscal displacements-extrusions, as well as the tibiofemoral cartilage thickness and
injury of the MCL, one of the basic ligaments supporting the knee medially, joint distances and meniscus
injury were investigated, and the findings were compared.
Results: A total of 94 knee MRIs of 46 female and 48 male patients with a mean age of 47.9 ± 12.7 were
evaluated. There was a significant correlation between medial joint space and medial meniscus extrusion
(MME) degree as the mean age of the patients increased. There was a positive correlation between medial
joint distance and medial and lateral cartilage thicknesses and lateral joint space. As the medial meniscus
damage degree increased, the medial cartilage thickness decreased and the MME degree was increased. In
addition, there was a negative correlation between lateral cartilage thickness and lateral meniscal extrusion
(LME) degree. There was a statistically significant difference between the groups with MME and MCL injury
(p <0,001).
Conclusion: Meniscal extrusion is a common finding with degenerative processes that increase with age.
The meniscal extrusion ratio is also increased in adjacent ligament damage such as MCL. Although both OA
and meniscopathy and ligament damage can be seen together, meniscal extrusion can be considered as a
cause of degenerative arthritis because it facilitates cartilage damage.
Keywords: Magnetic Resonance Imaging; Meniscus; osteoarthritis; Knee joint; Ligaments; MME

Keywords

MEDİAL MENİSKAL EKSTRÜZYON İLE DEJENERATİF ARTRİTİN NEDEN SONUÇ İLİŞKİSİ BAKIMINDAN İNCELENMESİ Investigation of the Cause-Effect Relationship Between Degenerative Arthritis and Medial Meniscal Extrusion

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