SPECIFIC DIAGNOSTIC SIGNIFICANCE OF “RIPPLE SIGN” OF MEDIAL FEMORAL CONDYLE UNDER ARTHROSCOPE IN MEDIAL LONGITUDINAL MENISCAL TEARS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

RENShiyou ¹ , SUNLimang ¹ , CHENGuofei ¹ , JIANGChangqing ² , ZHANGXintao ² ,  ZHANGWentao ²

1. Clinical College, Anhui Medical University & Peking University Shenzhen Hospital, Shenzhen Guangdong, 518036, P. R. China;
2. Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital;

Corresponding author：

ZHANGWentao, Email: zhangwt2007@sina.cn

Keywords：

Medial femoral condyle; Ripple sign; Medial longitudinal meniscal tears; Diagnosis

DOI：

10.7507/1002-1892.20150006

Video：

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Objective To investigate the reliability of the "ripple sign" on the upper surface of the medial femoral condyle in the diagnosis of medial longitudinal meniscal tears under arthroscope. Methods Between June 2013 and June 2014, 56 patients with knee injuries were included. There were 35 males and 21 females with an average age of 22.2 years (range, 12-38 years). The causes of injury were sports in 40 cases, falling in 10 cases, and traffic accident in 6 cases. The injury was located at the left knee in 22 cases and at the right knee in 34 cases. The disease duration was 10-40 days (mean, 20.2 days). Of 56 patients, 15 cases had simple medial meniscal injury; 41 cases had combined injuries, including anterior cruciate ligament injury in 38 cases, posterior cruciate ligament injury in 2 cases, and patellar dislocation in 1 case. The "ripple sign" was observed under arthroscope before operation. Repair of medial meniscal injury and reconstruction of cruciate ligament were performed. Results The positive "ripple sign" was seen under arthroscope in all patients, who were diagnosed to have longitudinal meniscal tears, including 23 cases of mild "ripple sign", 28 cases of moderate "ripple sign", and 5 cases of severe "ripple sign". Conclusion The "ripple sign" on the upper surface of the medial femoral condyle is a reliable diagnostic evidence of medial longitudinal meniscal tears.

Citation： RENShiyou, SUNLimang, CHENGuofei, JIANGChangqing, ZHANGXintao, ZHANGWentao. SPECIFIC DIAGNOSTIC SIGNIFICANCE OF “RIPPLE SIGN” OF MEDIAL FEMORAL CONDYLE UNDER ARTHROSCOPE IN MEDIAL LONGITUDINAL MENISCAL TEARS. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(1): 24-26. doi: 10.7507/1002-1892.20150006 Copy

1.	尚平, 许永涛, 廖全明, 等. 85例半月板损伤与关节软骨损伤相关性研究. 生物骨科材料与临床研究, 2004, 1(2):14-15.
2.	齐进, 夏亚一. 自体四股腘绳肌腱单束与双束重建前交叉韧带临床疗效的对比研究. 中国微创外科杂志, 2014, 14(1):12-15.
3.	Hensler D, Van Eck CF, Fu FH, et al. Anatomic anterior cruciate ligament reconstruction utilizing the double-bundle technique. J Orthop Sports Phys Ther, 2012, 42(3):184-195.
4.	李佳宇, 李巧红, 赵亮, 等. 关节镜下保留残端双股双隧道后交叉韧带重建术. 国际医药卫生导报, 2013, 19(9):1264-1268.
5.	Hensler D, Sillanpaa PJ, Schoettle PB. Medial patellofemoral ligament:anatomy, injury and treatment in the adolescent knee. Curr Opin Pediatr, 2014, 26(1):70-78.
6.	Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg (Br), 1961, 43-B:752-757.
7.	Anderson AF, Irrgang JJ, Dunn W, et al. Interobserver reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med, 2011, 39(5):926-932.
8.	燕树义, 高晓荣, 李学民, 等. 中老年人半月板损伤的关节镜诊断治疗. 中国修复重建外科杂志, 2006, 20(6):623-626.
9.	Widuchowski W, Widuchowski J, Trzaska T. Articular cartilage defects:Study of 25,124 knee arthroscopies. Knee, 2007, 14(3):177-182.
10.	廉会存. 60例半月板损伤并关节软骨损伤的临床观察. 河南外科学杂志, 2013, 19(3):39-40.
11.	胡跃林, 杨森源, 田得祥. 半月板撕裂与股骨髁半月板区关节软骨损伤的关系:附271例半月板手术治疗病例分析. 中国运动医学杂志, 1995, 14(2):79-83.
12.	刘祺, 郭林, 杨柳, 等. 膝关节半月板及股骨软骨损伤关节镜下标准化分区法及其临床应用. 创伤外科杂志, 2007, 9(3):203-205.
13.	仝路. 股骨内髁虚拟软骨缺损对膝关节软骨、半月板应力的影响. 昆明:昆明医科大学, 2013.
14.	李健辉, 冯世庆, 李建伟, 等. 髌内侧滑膜皱襞与对应股骨内侧髁软骨损伤关系的探讨. 中国矫形外科杂志, 2009, 17(16):1217-1220.
15.	Yoo JC, Ahn JH, Lee SH, et al. Increasing incidence of medial meniscal tears in nonoperatively treated anterior cruciate ligament insufficiency patients documented by serial magnetic resonance imaging studies. Am J Sports Med, 2009, 7(8):1478-1483.

1. 尚平, 许永涛, 廖全明, 等. 85例半月板损伤与关节软骨损伤相关性研究. 生物骨科材料与临床研究, 2004, 1(2):14-15.
2. 齐进, 夏亚一. 自体四股腘绳肌腱单束与双束重建前交叉韧带临床疗效的对比研究. 中国微创外科杂志, 2014, 14(1):12-15.
3. Hensler D, Van Eck CF, Fu FH, et al. Anatomic anterior cruciate ligament reconstruction utilizing the double-bundle technique. J Orthop Sports Phys Ther, 2012, 42(3):184-195.
4. 李佳宇, 李巧红, 赵亮, 等. 关节镜下保留残端双股双隧道后交叉韧带重建术. 国际医药卫生导报, 2013, 19(9):1264-1268.
5. Hensler D, Sillanpaa PJ, Schoettle PB. Medial patellofemoral ligament:anatomy, injury and treatment in the adolescent knee. Curr Opin Pediatr, 2014, 26(1):70-78.
6. Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg (Br), 1961, 43-B:752-757.
7. Anderson AF, Irrgang JJ, Dunn W, et al. Interobserver reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med, 2011, 39(5):926-932.
8. 燕树义, 高晓荣, 李学民, 等. 中老年人半月板损伤的关节镜诊断治疗. 中国修复重建外科杂志, 2006, 20(6):623-626.
9. Widuchowski W, Widuchowski J, Trzaska T. Articular cartilage defects:Study of 25,124 knee arthroscopies. Knee, 2007, 14(3):177-182.
10. 廉会存. 60例半月板损伤并关节软骨损伤的临床观察. 河南外科学杂志, 2013, 19(3):39-40.
11. 胡跃林, 杨森源, 田得祥. 半月板撕裂与股骨髁半月板区关节软骨损伤的关系:附271例半月板手术治疗病例分析. 中国运动医学杂志, 1995, 14(2):79-83.
12. 刘祺, 郭林, 杨柳, 等. 膝关节半月板及股骨软骨损伤关节镜下标准化分区法及其临床应用. 创伤外科杂志, 2007, 9(3):203-205.
13. 仝路. 股骨内髁虚拟软骨缺损对膝关节软骨、半月板应力的影响. 昆明:昆明医科大学, 2013.
14. 李健辉, 冯世庆, 李建伟, 等. 髌内侧滑膜皱襞与对应股骨内侧髁软骨损伤关系的探讨. 中国矫形外科杂志, 2009, 17(16):1217-1220.
15. Yoo JC, Ahn JH, Lee SH, et al. Increasing incidence of medial meniscal tears in nonoperatively treated anterior cruciate ligament insufficiency patients documented by serial magnetic resonance imaging studies. Am J Sports Med, 2009, 7(8):1478-1483.

Chinese Journal of Reparative and Reconstructive Surgery

SPECIFIC DIAGNOSTIC SIGNIFICANCE OF “RIPPLE SIGN” OF MEDIAL FEMORAL CONDYLE UNDER ARTHROSCOPE IN MEDIAL LONGITUDINAL MENISCAL TEARS

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