RESUMEN
In hemiarthroplasty for femoral head osteonecrosis, collapse and deformity may make femoral head measurement difficult, thus, precluding the selection of an appropriate prosthetic head. We describe a method for measuring the acetabular diameter using acetabular sizing gauges to estimate the prosthetic head size. We evaluated the precision of this method and found it to be highly accurate and reliable.
Asunto(s)
Acetábulo/anatomía & histología , Artroplastia de Reemplazo de Cadera , Necrosis de la Cabeza Femoral/cirugía , Prótesis de Cadera , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Diseño de PrótesisRESUMEN
Although several quantitative magnetic resonance (MR) diagnostic criteria for discoid lateral meniscus (DLM) have been described, there are no criteria by which to estimate the size of the medial meniscus. We define a medial meniscus that exceeds the normal size as a "large medial meniscus" (LMM), and the purpose of this study is to establish the quantitative MR diagnostic criteria for LMM. The MR imaging findings of 96 knees with arthroscopically confirmed intact semilunar lateral meniscus (SLM), 18 knees with intact DLM, 105 knees with intact semilunar medial meniscus (SMM) and 4 knees with torn LMM were analyzed. The following three quantitative parameters were measured: (a) meniscal width (MW): the minimum MW on the coronal slice; (b) ratio of the meniscus to the tibia (RMT): the ratio of minimum MW to maximum tibial width on the coronal slice; (c) continuity of the anterior and posterior horns (CAPH): the number of consecutive 5-mm-thick sagittal slices showing continuity between the anterior horn and the posterior horn of the meniscus on sagittal slices. Using logistic discriminant analysis between intact SLM and DLM groups and using descriptive statistics of intact SLM and SMM groups, the cutoff values used to discriminate LMM from SMM were calculated by MW and RMT. Moreover, the efficacy of these cutoff values and three slices of the cutoff values for CAPH were estimated in the medial meniscus group. "MW> or =11 mm" and "RMT> or =15%" were determined to be effective diagnostic criteria for LMM, while three of four cases in the torn LMM group were true positives and specificity was 99% in both criteria. When "CAPH> or =3 slices" was used as a criterion, three of four torn LMM cases were true positives and specificity was 93%.
Asunto(s)
Imagen Eco-Planar , Artropatías/diagnóstico , Meniscos Tibiales/crecimiento & desarrollo , Meniscos Tibiales/fisiopatología , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Articulación de la Rodilla/patología , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Lesiones de Menisco TibialRESUMEN
To establish the quantitative MR diagnostic criteria for discoid lateral meniscus, MR imaging of 60 knees with arthroscopically confirmed discoid lateral menisci and 134 knees with semilunar lateral menisci were analyzed. Following four quantitative parameters were measured. (1) Meniscal width (MW): The minimum meniscal width on the coronal slice. (2) Ratio of the meniscus to the tibia (RMT): The ratio of minimum meniscal width to maximum tibial width on the coronal slice. (3) Percent coverage of the meniscus (PCM): The ratio of the sum of the width of the anterior and posterior horns to the meniscal diameter on the sagittal slice showing the maximum meniscal diameter. (4) Continuity of the anterior and posterior horns (CAPH): The number of consecutive sagittal slices showing continuity between the anterior and posterior horns of the meniscus on the sagittal slice. The cut-off values of each parameter to discriminate between the discoid and semilunar meniscus were calculated based on a univariate logistic regression analysis. The sensitivity and specificity were also calculated for each of 4 parameters and combinations of these parameters. The cut-off value was 15 mm for the MW, 20% for the RMT, 75% for the PCM, and 3 slices for the CAPH. The sensitivity and specificity of the four parameters ranged between 87% and 50% and between 99% and 92%, respectively. The most accurate diagnostic criterion was either the RMT > or = 20% or the PCM > or = 75%, and the sensitivity and specificity were 95% and 97%, respectively, even when torn menisci were included.