دورية أكاديمية
أعرض في EDS

The Safe Distance to the Popliteal Neurovascular Bundle in Pediatric Knee Arthroscopic Surgery: An Age-Based Magnetic Resonance Imaging Anatomic Study.

التفاصيل البيبلوغرافية
العنوان: The Safe Distance to the Popliteal Neurovascular Bundle in Pediatric Knee Arthroscopic Surgery: An Age-Based Magnetic Resonance Imaging Anatomic Study.
المؤلفون: Schachne JM; Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Heath MR; Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA., Yen YM; Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Shea KG; Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA., Green DW; Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA., Fabricant PD; Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.
المصدر: Orthopaedic journal of sports medicine [Orthop J Sports Med] 2019 Jul 11; Vol. 7 (7), pp. 2325967119855027. Date of Electronic Publication: 2019 Jul 11 (Print Publication: 2019).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]-
مستخلص: Background: The close proximity of the popliteal neurovascular bundle to the posterior horn of the lateral meniscus puts it at risk of compromise during lateral meniscal repair. This is particularly important in smaller pediatric patients, who are commonly treated for lateral meniscal abnormalities in isolation (discoid meniscus) or concomitantly with anterior cruciate ligament reconstruction.
Purpose: To quantify the distance between the posterior horn of the lateral meniscus and the popliteal neurovascular bundle along the path of meniscal repair and to investigate for associations with age, sex, height, weight, body mass index (BMI), and skeletal maturity.
Study Design: Cross-sectional study; Level of evidence, 3.
Methods: A total of 144 magnetic resonance imaging scans were evaluated in a cohort of patients aged 10 to 18 years without meniscal or ligament abnormalities. Measurements were made along a line from the anterolateral portal between the popliteal neurovascular bundle and the free edge, midpoint, and meniscocapsular junctions of the posterior horn of the lateral meniscus. In addition to descriptive statistics of these distances by age and sex, analyses of variance and linear regression analyses were performed to investigate for associations with age, sex, height, weight, BMI, and skeletal maturity.
Results: Male participants had a significantly larger mean free edge distance (14.4 ± 2.5 vs 13.1 ± 2.5 mm, respectively; P = .005) and midpoint distance (9.6 ± 2.2 vs 8.9 ± 1.8 mm, respectively; P = .011) than female participants but not a significantly larger meniscocapsular distance (5.2 ± 1.6 vs 4.6 ± 1.4 mm, respectively; P = .096). Linear regression analyses revealed significant associations between these distances and age, height, weight, and BMI ( P < .001 for all). There were statistically significant pairwise differences for free edge and midpoint distances to the neurovascular bundle between patients with open and closed physes.
Conclusion: The distance between the posterior horn of the lateral meniscus and the popliteal vasculature along a trajectory from the standard anterolateral arthroscopic portal increases linearly throughout development between the ages of 10 and 18 years. There were also significant associations between height, weight, BMI, and skeletal maturity and these anatomic distances. Knowing the safe distance to the popliteal vasculature will increase the safety of arthroscopic lateral meniscal repair in children, especially with all-inside devices that require setting the penetration depth for the advancement of a sharp delivery device beyond the posterior capsule.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: Y.-M.Y. is a paid consultant for OrthoPediatrics and Smith & Nephew. K.G.S. has received research support from AlloSource and Vericel, is an unpaid consultant for Clinical Data Solutions and SourceTrust, is a paid consultant for HealthTrust, and has received hospitality payments from DePuy and Sanofi-Aventis. D.W.G. receives royalties from Arthrex, Pega Medical, and Wolters Kluwer Health; is a paid consultant for Arthrex; and is a paid speaker/presenter for Synthes. P.D.F. has received educational support and hospitality payments from Smith & Nephew and Medical Device Business Services. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
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فهرسة مساهمة: Keywords: anatomy; knee; magnetic resonance imaging; meniscus; pediatric sports medicine
تواريخ الأحداث: Date Created: 20190720 Latest Revision: 20220409
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC6624919
DOI: 10.1177/2325967119855027
PMID: 31321247
قاعدة البيانات: MEDLINE
الوصف
تدمد:2325-9671
DOI:10.1177/2325967119855027