前交叉韧带损伤膝关节中的外侧半月板后根部撕裂：当前认识
简介
这篇叙述性综述聚焦ACL损伤膝合并外侧半月板后根部撕裂（LMPRT），并强调其与外侧半月板斜行放射状撕裂（LMORT）的区分。LMPRT发生率随病变定义和确认方式差异很大：原发ACLR队列报告为7.1%、10.0%和12.2%，混合原发/翻修队列为6.6%，部分翻修队列达20.5%和40.7%；单项MRI征象敏感度有限，需结合多项征象及关节镜下探查和探针检查…
英文摘要
Lateral meniscus posterior root tears (LMPRTs) compromise load transmission and secondary stability in the anterior cruciate ligament (ACL)-injured knee and may be missed on magnetic resonance imaging (MRI). This narrative current-concepts review addresses incidence, risk factors, biomechanics, diagnosis, classification, treatment, and outcomes, while distinguishing root tears from lateral meniscal oblique radial tears (LMORTs). Primary ACL reconstruction (ACLR) cohorts report LMPRT frequencies of 7.1%, 10.0%, and 12.2%; a mixed primary/revision cohort reports 6.6% and selected revision cohorts report 20.5% and 40.7%. These study-specific estimates differ in lesion definition and ascertainment. Contact injury, concomitant medial meniscal pathology, and increased lateral posterior tibial slope are recurring associations. Individual MRI signs have limited sensitivity; combined assessment and arthroscopic inspection and probing support diagnosis. LaPrade et al. describe root-tear morphology, Forkel and Petersen additionally consider meniscofemoral ligament integrity, and LMORT typing describes posterior-horn oblique radial tears. The systems overlap for near-root lesions and are descriptive frameworks rather than validated treatment algorithms. Selected stable lesions may be observed; repairable unstable lesions are generally treated with footprint fixation or side-to-side repair, according to anatomy and tissue quality. Repair with ACLRn is associated with improved patient-reported outcomes and high complete-or-partial healing proportions in selected series. Clinical improvement in ACL graft survivorship has not been demonstrated. Heterogeneous definitions, predominantly lower-level evidence, variable rehabilitation, and limited long-term comparative data, constrain conclusions about cartilage preservation and optimal treatment.