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前交叉韧带重建术中半月板修复的成功率。

Success of meniscal repair at anterior cruciate ligament reconstruction.

作者信息

Toman Charles V, Dunn Warren R, Spindler Kurt P, Amendola Annunziata, Andrish Jack T, Bergfeld John A, Flanigan David, Jones Morgan H, Kaeding Christopher C, Marx Robert G, Matava Matthew J, McCarty Eric C, Parker Richard D, Wolcott Michelle, Vidal Armando, Wolf Brian R, Huston Laura J, Harrell Frank E, Wright Rick W

机构信息

Department of Orthopaedic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri 63110, USA.

出版信息

Am J Sports Med. 2009 Jun;37(6):1111-5. doi: 10.1177/0363546509337010.

Abstract

BACKGROUND

Meniscal repair is performed in an attempt to prevent posttraumatic arthritis resulting from meniscal dysfunction after meniscal tears. The socioeconomic implications of premature arthritis are significant in the young patient population. Investigations and techniques focusing on meniscus preservation and healing are now at the forefront of orthopaedic sports medicine.

HYPOTHESIS

Concomitant meniscal repair with anterior cruciate ligament reconstruction is a durable and successful procedure at 2-year follow-up.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

All unilateral primary anterior cruciate ligament reconstructions entered in 2002 in a cohort who had meniscal repair at the time of anterior cruciate ligament reconstruction were evaluated. Validated patient-oriented outcome instruments were completed preoperatively and then again at the 2-year postoperative time point. Reoperation after the index procedure was also documented and confirmed by operative reports.

RESULTS

A total of 437 unilateral primary anterior cruciate ligament reconstructions were performed with 82 concomitant meniscal repairs (54 medial, 28 lateral) in 80 patients during the study period. Patient follow-up was obtained on 94% (77 of 82) of the meniscal repairs, allowing confirmation of meniscal repair success (defined as no repeat arthroscopic procedure) or failure. The overall success rate for meniscal repairs was 96% (74 of 77 patients) at 2-year follow-up.

CONCLUSION

Meniscal repair is a successful procedure in conjunction with anterior cruciate ligament reconstruction. When confronted with a "repairable" meniscal tear at the time of anterior cruciate ligament reconstruction, orthopaedic surgeons can expect an estimated >90% clinical success rate at 2-year follow-up using a variety of methods as shown in our study.

摘要

背景

半月板修复旨在预防半月板撕裂后因半月板功能障碍导致的创伤后关节炎。过早发生关节炎对年轻患者群体具有重大的社会经济影响。专注于半月板保留和愈合的研究及技术目前处于骨科运动医学的前沿。

假设

在2年随访中,前交叉韧带重建联合半月板修复是一种持久且成功的手术。

研究设计

病例系列;证据等级,4级。

方法

对2002年纳入队列的所有单侧初次前交叉韧带重建患者进行评估,这些患者在进行前交叉韧带重建时同时进行了半月板修复。术前及术后2年时间点均完成了经过验证的以患者为导向的结局评估工具。初次手术后的再次手术情况也通过手术报告进行记录和确认。

结果

在研究期间,共对80例患者进行了437例单侧初次前交叉韧带重建,其中82例同时进行了半月板修复(内侧54例,外侧28例)。对82例半月板修复患者中的94%(77例)进行了随访,从而能够确认半月板修复成功(定义为无需再次进行关节镜手术)或失败。在2年随访时,半月板修复的总体成功率为96%(77例患者中的74例)。

结论

半月板修复联合前交叉韧带重建是一种成功的手术。当在前交叉韧带重建时遇到“可修复”的半月板撕裂时,骨科医生可以预期,如我们的研究所显示的,采用多种方法在2年随访时临床成功率估计>90%。

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