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关节镜下全内修复治疗合并前交叉韧带重建的外侧半月板根部撕裂的疗效。

Results of arthroscopic all-inside repair for lateral meniscus root tear in patients undergoing concomitant anterior cruciate ligament reconstruction.

机构信息

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

出版信息

Arthroscopy. 2010 Jan;26(1):67-75. doi: 10.1016/j.arthro.2009.07.007.

Abstract

PURPOSE

To evaluate the effectiveness of all-inside repair of posterior lateral meniscus root full-thickness tears with preoperative and postoperative magnetic resonance imaging (MRI) and to propose a system of classifying posterior lateral meniscus root tears.

METHODS

From June 2003 to March 2007, 27 (6.95%) of a consecutive series of 388 anterior cruciate ligament reconstructions had a concomitant posterior lateral meniscus root tear. Of the patients, 25 (92.6%) were followed up for a more than 1 year. There were 22 male and 3 female patients, with a mean age of 28.8 years. The mean timing of surgery after injury was 40.8 months. The preoperative and postoperative MRI scans were analyzed and compared. We classified posterior lateral meniscus root tears according to arthroscopic findings.

RESULTS

There was no postoperative effusion, joint-line tenderness, or positive McMurray provocation testing observed at the last follow-up. No statistically significant improvement was observed in the coronal plane in the 18 follow-up MRI scans (P = .096); however, sagittal extrusion improved significantly (P = .007). Posterior lateral meniscus root tears were classified based on arthroscopic findings: type I, oblique flap; type II, T shape; type III, longitudinal cleavage; or type IV, chronic inner loss. A type I tear was found in 7 patients, type II in 4, type III in 4, and type IV in 10.

CONCLUSIONS

After repair of posterior lateral meniscus root tears, MRI showed that the displaced lateral meniscus was reduced, mainly in the sagittal plane. Posterior lateral meniscus root tears were classified based on arthroscopic findings: type I, oblique flap; type II, T shape; type III, longitudinal cleavage; or type IV, chronic inner loss.

摘要

目的

通过术前和术后磁共振成像(MRI)评估全内修复后外侧半月板根部全层撕裂的效果,并提出一种后外侧半月板根部撕裂的分类系统。

方法

2003 年 6 月至 2007 年 3 月,连续 388 例前交叉韧带重建中,有 27 例(6.95%)合并后外侧半月板根部撕裂。其中 25 例(92.6%)患者随访时间超过 1 年。患者 22 例为男性,3 例为女性,平均年龄 28.8 岁。受伤后手术平均时间为 40.8 个月。分析并比较术前和术后 MRI 扫描结果。我们根据关节镜检查结果对后外侧半月板根部撕裂进行分类。

结果

末次随访时无术后积液、关节线压痛或麦氏征阳性。18 例随访 MRI 扫描在冠状面无明显改善(P =.096);然而矢状面外突明显改善(P =.007)。后外侧半月板根部撕裂根据关节镜检查结果分类:Ⅰ型,斜形瓣;Ⅱ型,T 形;Ⅲ型,纵裂;或Ⅳ型,慢性内失。7 例为Ⅰ型撕裂,4 例为Ⅱ型,4 例为Ⅲ型,10 例为Ⅳ型。

结论

后外侧半月板根部撕裂修复后,MRI 显示外侧半月板移位减少,主要在矢状面。后外侧半月板根部撕裂根据关节镜检查结果分类:Ⅰ型,斜形瓣;Ⅱ型,T 形;Ⅲ型,纵裂;或Ⅳ型,慢性内失。

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