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关节镜下半月板缝合修复术后膝关节的旋转稳定性:对孤立性内侧和外侧半月板撕裂的5至17年随访研究

Rotatory stability of the knee after arthroscopic meniscus suture repair: a 5-to-17-year follow-up study of isolated medial and lateral meniscus tears.

作者信息

Majewski Martin, Stoll Reinhard, Müller Werner, Friederich Niklaus E

机构信息

Kantonsspital Bruderholz, Bruderholz, Switzerland.

出版信息

Acta Orthop Belg. 2009 Jun;75(3):354-9.

Abstract

The long-term rotatory stability of meniscus suture repair has not been firmly established clinically. Up to now there are only experimental studies done. This retrospective study aimed to compare the long-term rotatory stability of a knee with a meniscus suture repair with the stability of the uninjured knee in each of a cohort of patients. We evaluated both knees of 64 patients at an average follow-up of 11 years (range : 5 to 17) after successful arthroscopic meniscus suture repair. Each patient's injury was an isolated longitudinal-vertical meniscus tear and each patient's opposite knee was uninjured. All repairs were performed with the same outside in meniscus suture repair technique. Evaluation included standardised clinical examination, anterior stability testing with a ligament testing device, and rotational testing with a rotational laxiometer. In the stability assessments, the mean anteroposterior translation was the same for repaired and uninjured knees: 3 mm at 67 N and 5 mm at 89 N. The mean external rotation was the same in repaired knees and uninjured knees at 20 degrees of flexion (22 degrees) and similar in repaired knees (22 degrees) and uninjured knees (23 degrees) at 90 degrees flexion. The mean internal rotation was similar in repaired knees (12 degrees) and uninjured knees (13 degrees) at 20 degrees and 90 degrees of flexion. Our findings indicate that a knee with arthroscopic meniscus suture repair displays a rotational stability that is equal to or nearly equal to the stability of an uninjured knee. However, whether rotational stability will only be preserved due to meniscus repair and how much of the meniscus needs to be preserved in order to maintain the biomechanical stability of the knee remains unclear.

摘要

半月板缝合修复的长期旋转稳定性在临床上尚未得到确切证实。到目前为止,仅有一些实验性研究。这项回顾性研究旨在比较一组患者中,半月板缝合修复后的膝关节与未受伤膝关节的长期旋转稳定性。我们对64例患者在成功进行关节镜下半月板缝合修复后平均随访11年(范围:5至17年)的双侧膝关节进行了评估。每位患者的损伤均为孤立的纵向垂直半月板撕裂,且对侧膝关节未受伤。所有修复均采用相同的由外向内半月板缝合修复技术。评估包括标准化临床检查、使用韧带测试装置进行前向稳定性测试以及使用旋转测角仪进行旋转测试。在稳定性评估中,修复膝关节与未受伤膝关节的平均前后平移相同:67N时为3mm,89N时为5mm。在20度屈曲时,修复膝关节与未受伤膝关节的平均外旋相同(22度),在90度屈曲时,修复膝关节(22度)与未受伤膝关节(23度)相似。在20度和90度屈曲时,修复膝关节(12度)与未受伤膝关节(13度)的平均内旋相似。我们的研究结果表明,关节镜下半月板缝合修复后的膝关节显示出的旋转稳定性等于或几乎等于未受伤膝关节的稳定性。然而,旋转稳定性是否仅因半月板修复而得以保留,以及为维持膝关节的生物力学稳定性需要保留多少半月板仍不清楚。

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