Koukoulias Nikolaos, Papastergiou Stergios, Kazakos Konstantinos, Poulios Georgios, Parisis Konstantinos
Department of Orthopaedics, Sports Injuries Unit, Agios Pavlos General Hospital, 161 Ethnikis Antistasis Street, 55134 Thessaloniki, Greece.
Knee Surg Sports Traumatol Arthrosc. 2007 Feb;15(2):138-43. doi: 10.1007/s00167-006-0162-2. Epub 2006 Sep 12.
The medial meniscus is a secondary stabilizer to anterior tibial translation and provides significant stability, especially in an ACL-deficient knee. The purpose of this study is to evaluate the clinical outcome of medial meniscus repair in the unstable knee. Between 1997 and 2002, 11 patients, with a mean age of 25.8 years (range 15-39 years), underwent all-inside medial meniscus repair, using the Meniscus Arrow, for unstable medial meniscus tear in ACL-deficient knees. For various reasons none of these patients underwent ACL reconstruction. The average follow-up was 73 months (range 52-91 months). There were three failures (27.3%) defined as the need for reoperation and partial meniscectomy. The mean Tegner activity score decreased from 6.75 (pretrauma) to 4.5 (postoperatively). The average Lysholm and subjective IKDC scores were 83 and 77.4, respectively. Two patients were graded as B (nearly normal) and six as C (abnormal), according to the IKDC knee evaluation form. KT-2000 arthrometry demonstrated that sagittal knee laxity was more than 5 mm in all knees (side to side difference). MRI demonstrated grade three signal alterations at the repair site of meniscus in three patients and signs of cartilage damage in two patients. All patients were asymptomatic during daily activities but seven out of eight reported pain or effusion after sports. Medial meniscus repair in the ACL-deficient knee is not contraindicated. The need of reducing the level of physical activity is essential.
内侧半月板是胫骨前移的次要稳定结构，能提供显著的稳定性，尤其是在ACL缺失的膝关节中。本研究的目的是评估不稳定膝关节内行内侧半月板修复的临床效果。1997年至2002年间，11名平均年龄为25.8岁（15 - 39岁）的患者，因ACL缺失膝关节的不稳定内侧半月板撕裂，采用半月板箭进行全内内侧半月板修复。由于各种原因，这些患者均未进行ACL重建。平均随访时间为73个月（52 - 91个月）。有3例失败（27.3%），定义为需要再次手术和部分半月板切除术。Tegner活动评分平均从6.75（创伤前）降至4.5（术后）。Lysholm和主观IKDC评分平均分别为83和77.4。根据IKDC膝关节评估表，2例患者评为B级（接近正常），6例评为C级（异常）。KT - 2000关节测量仪显示，所有膝关节矢状面松弛度均超过5mm（双侧差异）。MRI显示3例患者半月板修复部位有三级信号改变，2例患者有软骨损伤迹象。所有患者在日常活动中均无症状，但8例中有7例报告运动后疼痛或积液。ACL缺失膝关节的内侧半月板修复并非禁忌。降低体力活动水平是必要的。
