Shelbourne K. Donald, Rask Bart P.
Methodist Sports Medicine Center, Indianapolis, Indiana (K.D.S.); and the Hillsboro Orthopaedic Group, Hillsboro, Oregon (B.P.R.), U.S.A.
Arthroscopy. 2001 Mar;17(3):270-274. doi: 10.1053/jars.2001.19978.
To determine the clinical sequelae of nondegenerative peripheral vertical medial meniscus tears treated with abrasion and trephination alone (stable tears) or suture repair (unstable tears). Type of Study: Cohort follow-up. METHODS: At the time of anterior cruciate ligament reconstruction, 548 patients had nondegenerative peripheral vertical medial meniscus tears that were either left unsutured or repaired. Of 548 menisci, 233 were stable and were abraded and trephined (AT group), 139 were stable and left in situ (Situ group), and 176 were unstable and were repaired with sutures (Suture group). An unstable tear was defined as a torn meniscus that could be displaced into the intercondylar notch with a probe. Patients who had no medial or lateral meniscal tears at the time of ACL reconstruction served as a control population (No Tear group, n = 526). Subjective follow-up was obtained with a modified Noyes questionnaire. RESULTS: Objective follow-up was obtained at a mean of 4.8 +/- 1.7 years postoperatively. Subjective follow-up was obtained at a mean of 7.3 +/- 3.4 years postoperatively. At a mean of 3.7 years (range, 4 months to 10.7 years) after the reconstruction, a subsequent arthroscopy was required for 14 patients (6.0%) in the AT group, 15 patients (10.8%) in the Situ group, 24 patients (13.6%) in the Suture group, and 15 patients (2.9%) in the No Tear group; these numbers were not statistically significant. The mean total subjective score was not statistically significantly different between groups. CONCLUSIONS: Repaired unstable peripheral vertical medial meniscus tears have a failure rate of 13.6%, most retears occurring more than 2 years after repair. Of stable peripheral vertical medial meniscus tears treated with abrasion and trephination, most (94%) remain asymptomatic without stabilization.
确定单独采用磨损和钻孔术治疗(稳定撕裂)或缝合修复(不稳定撕裂)的非退行性外周垂直内侧半月板撕裂的临床后遗症。研究类型:队列随访。方法:在前交叉韧带重建时,548例患者存在非退行性外周垂直内侧半月板撕裂,这些撕裂要么未缝合,要么进行了修复。在548个半月板中,233个是稳定的,进行了磨损和钻孔术(AT组),139个是稳定的,未作处理(原位组),176个是不稳定的,进行了缝合修复(缝合组)。不稳定撕裂定义为用探针可将撕裂的半月板移位至髁间切迹的情况。前交叉韧带重建时无内侧或外侧半月板撕裂的患者作为对照人群(无撕裂组,n = 526)。采用改良的诺伊斯问卷进行主观随访。结果:术后平均4.8±1.7年进行了客观随访。术后平均7.3±3.4年进行了主观随访。重建后平均3.7年(范围4个月至10.7年),AT组有14例患者(6.0%)、原位组有15例患者(10.8%)、缝合组有24例患者(13.6%)、无撕裂组有15例患者(2.9%)需要再次进行关节镜检查;这些数字无统计学差异。各组间总的主观评分均值无统计学显著差异。结论:修复的不稳定外周垂直内侧半月板撕裂的失败率为13.6%,大多数再撕裂发生在修复后2年以上。在采用磨损和钻孔术治疗的稳定外周垂直内侧半月板撕裂中,大多数(94%)未经稳定处理仍无症状。