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前交叉韧带重建膝关节内侧半月板修复的临床和二次关节镜评估。

Clinical and second-look arthroscopic evaluation of repaired medial meniscus in anterior cruciate ligament-reconstructed knees.

机构信息

Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.

出版信息

Am J Sports Med. 2010 Mar;38(3):472-7. doi: 10.1177/0363546509348102. Epub 2010 Jan 23.

Abstract

BACKGROUND

Tears of the medial meniscus posterior horn (MMPH) are frequently found in knees with deficient anterior cruciate ligaments (ACLs). There are few studies that have evaluated healing of the menisci and the factors associated with healing.

HYPOTHESIS

The repaired menisci would show good healing in the knees with reconstructed ACLs, and the healing capacity of the menisci would differ according to the size, type, and location of the tear as well as the age and gender.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

From August 1997 to February 2007, 311 knees underwent MMPH repair using either a modified all-inside or inside-out technique with concomitant ACL reconstruction. Among these patients, a second-look arthroscopy was performed at a mean of 37.7 months postoperatively (range, 12-128 months) in 140 patients. Clinical parameters and outcomes were evaluated. The repaired menisci were divided into complete, incomplete, and failure-to-heal groups. The factors associated with meniscal healing were statistically assessed.

RESULTS

Among 140 patients, 118 (84.3%) showed complete healing, 17 (12.1%) had incomplete healing, and 5 (3.6%) failed to heal. The clinical success rate was 96.4% (135/140) because patients in the incomplete group showed no clinical symptoms associated with meniscal tears. Healing was associated with the tear location (P <.001) and type of tear (P =.0237) on the univariate analysis and the location (P =.0401) only on the multivariate analysis.

CONCLUSION

Repaired MMPH tears in knees with reconstructed ACLs healed without complications and had satisfactory clinical results. The tear location and type were factors associated with healing on the univariate analysis and location only on the multivariate analysis.

摘要

背景

内侧半月板后角撕裂(MMPH)在 ACL 缺失的膝关节中经常发现。很少有研究评估半月板的愈合情况以及与愈合相关的因素。

假设

ACL 重建后的膝关节中,修复的半月板会有良好的愈合,半月板的愈合能力会因撕裂的大小、类型和位置以及年龄和性别而有所不同。

研究设计

病例系列;证据水平,4 级。

方法

1997 年 8 月至 2007 年 2 月,311 例膝关节采用改良全内或内-外技术修复 MMPH,并同时进行 ACL 重建。在这些患者中,140 例患者在术后平均 37.7 个月(12-128 个月)进行了二次关节镜检查。评估临床参数和结果。将修复的半月板分为完全愈合、不完全愈合和未愈合组。对与半月板愈合相关的因素进行统计学评估。

结果

在 140 例患者中,118 例(84.3%)显示完全愈合,17 例(12.1%)显示不完全愈合,5 例(3.6%)未愈合。临床成功率为 96.4%(135/140),因为不完全愈合组的患者没有与半月板撕裂相关的临床症状。在单因素分析中,愈合与撕裂位置(P <.001)和撕裂类型(P =.0237)相关,而在多因素分析中仅与撕裂位置(P =.0401)相关。

结论

ACL 重建后膝关节内 MMPH 撕裂修复后无并发症,临床结果满意。撕裂位置和类型是单因素分析中与愈合相关的因素,而在多因素分析中仅与位置相关。

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