Department of Orthopedic Surgery and the Sports Medicine Center, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Am J Sports Med. 2010 May;38(5):976-82. doi: 10.1177/0363546509354055. Epub 2010 Mar 18.
There are sparse data available regarding outcome of meniscal repair performed at the time of ACL reconstruction in the pediatric and adolescent population.
To review the results of meniscal repair performed at the time of ACL reconstruction in pediatric and adolescent patients.
Case series; Level of evidence, 4.
The records of all patients age 18 years or younger who underwent meniscal repair at the time of ACL reconstruction between 1990 and 2005 were reviewed. Ninety-nine patients (56 female, 43 male) with an average age of 16 years (range, 13-18) were included. Average injury to surgery interval was 107 days (range, 2-1109). Clinical outcomes were assessed at a mean of 8 years postoperatively (range, 2-19). A multivariate model was used to compare this cohort with a previously published cohort of patients with isolated meniscal tears.
The clinical success rate of meniscal repair was 84% for simple tears, 59% for displaced bucket-handle tears, and 57% for complex tears (74% overall). Twenty-six menisci (26% overall) failed repair and 25 patients underwent repeat arthroscopic surgery (19 partial meniscectomies, 6 re-repairs). The average Tegner and International Knee Documentation Committee scores were 6.2 (range, 2-10) and 90.3 (range, 52-100), respectively. Risk factors for failure included complex and bucket-handle tear (P = .01), medial meniscal tears (P = .03), and skeletal immaturity (P = .01). Compared with isolated meniscal repairs in a similar pediatric and adolescent population, complex tears repaired in combination with ACL reconstruction did significantly better (57% vs 13%; P = .004).
Clinically successful repair of meniscal tears treated at the time of ACL reconstruction in patients 18 years or younger depends on tear type, with complex and bucket-handle tears being negative prognostic factors. Complex tears have a higher rate of clinical success when repaired at the time of ACL reconstruction versus when repaired in isolation.
有关儿童和青少年人群中前交叉韧带重建时半月板修复的结果的数据很少。
回顾前交叉韧带重建时半月板修复的结果。
病例系列；证据水平，4 级。
回顾了 1990 年至 2005 年间接受前交叉韧带重建时半月板修复的所有 18 岁以下患者的记录。纳入 99 例患者（56 例女性，43 例男性），平均年龄 16 岁（范围，13-18 岁）。平均受伤至手术间隔为 107 天（范围，2-1109 天）。术后平均 8 年（范围，2-19 年）进行临床评估。使用多变量模型将本队列与之前发表的单纯半月板撕裂患者队列进行比较。
单纯撕裂的半月板修复临床成功率为 84%，移位桶柄状撕裂为 59%，复杂撕裂为 57%（总体为 74%）。26 个半月板（总体 26%）修复失败，25 例患者接受了再次关节镜手术（19 例部分半月板切除术，6 例再次修复）。平均 Tegner 和国际膝关节文献委员会评分分别为 6.2（范围，2-10）和 90.3（范围，52-100）。失败的危险因素包括复杂和桶柄状撕裂（P =.01）、内侧半月板撕裂（P =.03）和骨骼不成熟（P =.01）。与类似的儿童和青少年人群中的单纯半月板修复相比，前交叉韧带重建时修复的复杂撕裂明显更好（57%对 13%；P =.004）。
在 18 岁或以下的患者中，前交叉韧带重建时半月板撕裂的临床成功修复取决于撕裂类型，复杂和桶柄状撕裂是负面的预后因素。与单独修复相比，前交叉韧带重建时修复复杂撕裂的临床成功率更高。
