Steenbrugge F, Corteel J, Verdonk R, Verstraete K
Département de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Gand, 9000 Gand, Belgique.
Rev Chir Orthop Reparatrice Appar Mot. 2003 Dec;89(8):699-706.
A prospective study was set up to evaluate meniscal suturing using an inside-out technique.
Of an initial group of 20 patients who underwent closed meniscus repair between 1985 and 1988 using an inside-out technique, 13 were studied. All patients were subjected to a clinical examination and an magnetic resonance imaging (MRI) investigation. The findings were compared with those of their previous follow-up examination (1994). The Hospital for Special Surgery (HSS) knee rating system was used. The study included 7 men and 6 women, ranging in age from 29 years to 50 years (mean age: 35 years 6 months). The mean follow-up was 13 years 2 months (11 years 11 months-15 years 4 months). Six left and 7 right knees were involved. Seven patients also had an anterior cruciate ligament (ACL) injury of which one was repaired 6 years after meniscal repair.
All patients obtained an HSS score of more than 75%. In all patients the site of the previous suture was still visible on MRI mainly by small metal artefacts in the meniscus. Patients with an unrepaired ACL lesion had an early onset of arthrosis and cartilage degeneration.
Meniscal suturing gives good clinical long-term results. Magnetic resonance imaging, however, showed signs of mucoid degeneration or scar tissue in 46% of the patients.
开展一项前瞻性研究以评估使用由外向内技术进行半月板缝合的效果。
在1985年至1988年间，最初有20例患者采用由外向内技术接受了闭合性半月板修复手术，其中13例纳入研究。所有患者均接受了临床检查和磁共振成像（MRI）检查。将检查结果与其先前（1994年）的随访检查结果进行比较。采用特种外科医院（HSS）膝关节评分系统。该研究包括7名男性和6名女性，年龄在29岁至50岁之间（平均年龄：35岁6个月）。平均随访时间为13年2个月（11年11个月至15年4个月）。累及6个左膝和7个右膝。7例患者还伴有前交叉韧带（ACL）损伤，其中1例在半月板修复6年后进行了ACL修复。
所有患者的HSS评分均超过75%。在所有患者中，先前缝合部位在MRI上仍可见，主要表现为半月板内的小金属伪影。未修复ACL损伤的患者出现关节病和软骨退变的时间较早。
半月板缝合在临床上可取得良好的长期效果。然而，磁共振成像显示46%的患者存在黏液样变性或瘢痕组织迹象。
