The Observation Of Tibial Plateau Injury By Discoid Meniscus In The Surface Replacement Of Knee Osteoarthritis

Objective: To investigate the characteristics of articular cartilage injury on the medial tibial plateau with knee osteoarthritis(KOA)and discoid meniscus,and to analyze the role of discoid meniscus in the occurrence and progress of knee osteoarthritis.Materials and methods: From August 2016 to January 2018,patients who suffered from KOA and underwent total knee arthroplasty in the joint surgery of the First Affiliated Hospital of Guangxi Medical University was elected as a research sample.According to the type of meniscus seen in the operation,the cases were divided into discoid meniscus group(DM group)and non-disc meniscus group(non-DM group).The meniscus type of discoid meniscus was selected in 28 cases and 32 knees.There are 3 men(with 5 knees)and 25 women(with 27 knees)among them;As a contrast,At the same time,30 cases(34knees)of the meniscus with non discoid meniscus were randomly selected according to the inclusion criteria.There are 6 men(with 7 knees)and 24women(with 27 knees)among them.A total of 58 cases(66 knees),There are 9men(with 12 knees)and 49 women(with 54 knees)in all of the patients which age from 53 to 81,average age of(65.8±7.6)years.Using Weidow naked eyeclassificiation method to analyze all the samples of the study,and the medial tibial plateau was divided into 3 equal areas according to the longest anteroposterior diameter,which was marked as anterior area,central area,posterior area.If the wear of articular cartilage were involved in two areas,which was marked as antero-middle,postero-middle.If the wear of articul-ar cartilage was involved in three areas,which was marked as all areas.All cases were operated by the same operator,the damaged conditions of articular cartilage on the medial tibial plateau and the types of meniscus were recorded by the same people.Result: According to the intraoperative meniscus eye classification and articular cartilage wear Weidow visual grading all 58 cases of 66 knees,tibial plateau articular cartilage degeneration weidow classification,which DM group2(4 knees)12.5%;Grade 3(10 knees)accounted for 31.2%;Grade 4(18 knees)accounted for 56.3%;Non-DM group Grade 2(3 knees)accounted for 8.8%;Grade 3(21 knees)accounted for 61.8%;4(10knees)accounted for 29.4%;the mean value of weidow grading in the three regions of the medial compartment tibia was statistically analyzed,and the average of the weidow grading of the three regions of the tibial media in the DM group was(3.68±0.53);The average of the weidow grading in the three regions of the medial compartment of the non-DM group was(3.03±0.69).Study of cartilage injury area through medial tibial plateau showed that the most common area of the medial tibial plateau in the DM group was found in the anterior area,followed by the central area and the anterior central area,accounting for 35.2%,26.8%,and 14.6%,respectively;The most common area of the medial tibial plateau in the non-DM group was found in the anterior central area,followed by the central area and the whole area,accounting for 37.8%,26.7%,and 15.6%,respectively.Conclusion: 1)Among knee osteoarthritis treated with total knee arthroplasty,the most common cartilage injury area of the medial tibial plateau in the DM group was found in the anterior area,followed by the central area;while the most common area of the medial tibial plateau in the non-DM group was found in the anterior central area,followed by the central area.2)Compared to the normal type of meniscus in OA,OA combined with discoid meniscus which cartilage degeneration of the medial tibial plateau is heavier.