Department of Orthopaedic Surgery, Chungnam National University College of Medicine, 640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea.
Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1546-52. doi: 10.1007/s00167-012-2131-2. Epub 2012 Jul 17.
To evaluate the reparability of the posterior horn of the medial meniscus with root ligament tear by measuring the actual pullout failure strength of a simple vertical suture of an arthroscopic subtotal meniscectomized posterior horn of the medial meniscus.
From November 2009 to May 2010, nine posterior horns of the medial meniscus specimens were collected from arthroscopic subtotal meniscectomy performed as a treatment for root ligament rupture of the posterior horn of the medial meniscus. Simple vertical sutures were performed on the specimens, and pullout failure load was tested with a biaxial servohydraulic testing machine (Model 8874; Instron Corp., Norwood, MA, USA). The degree of degeneration, extrusion, and medial displacement of the medial meniscus were evaluated with magnetic resonance imaging (MRI). The Kellgren-Lawrence classification was used in standing plain radiography, and mechanical alignment was measured using orthoroentgenography. Tear morphology was classified into ligament proper type or meniscoligamentous junctional type according to the site of the torn root ligament of the posterior horn of the medial meniscus during arthroscopy.
The mean pullout failure strength of the posterior horn of the medial meniscus was 71.6 ± 23.2 N (range, 41.4-107.7 N). The degree of degeneration of the posterior horn of the medial meniscus on MRI showed statistically significant correlation with pullout failure strength and Kellgren-Lawrence classification. Pullout failure strength showed correlation with mechanical alignment and Kellgren-Lawrence classification (P < 0.05).
The measurement of pullout failure strength of the posterior horn of the medial meniscus with root ligament tear showed a degree of repairability. The degree of degeneration of the posterior horn of the medial meniscus on MRI showed a significant correlation with the pullout failure strength. The pullout failure strength was also not only correlated with the degree of degeneration of the posterior horn of the medial meniscus, but also with mechanical alignment and Kellgren-Lawrence classification, which represent bony degenerative change.
通过测量关节镜下内侧半月板后角部分切除术的后角的单纯垂直缝合的实际拔出失效强度，来评估内侧半月板后角合并根韧带撕裂的可修复性。
2009 年 11 月至 2010 年 5 月，我们从关节镜下内侧半月板后角根韧带撕裂的部分切除术患者中收集了 9 个内侧半月板后角标本。对标本进行单纯垂直缝合，并使用双轴液压试验机（型号 8874；Instron 公司，马萨诸塞州诺伍德）进行拔出失效负荷测试。使用磁共振成像（MRI）评估内侧半月板的退变、挤出和内侧移位程度。在站立位平片上使用 Kellgren-Lawrence 分级，使用 orthoroentgenography 测量机械对线。根据关节镜下内侧半月板后角撕裂的根韧带撕裂部位，将撕裂形态分为韧带型或半月板-韧带结合部型。
内侧半月板后角的平均拔出失效强度为 71.6±23.2N（范围 41.4-107.7N）。MRI 上内侧半月板后角的退变程度与拔出失效强度和 Kellgren-Lawrence 分级呈统计学显著相关。拔出失效强度与机械对线和 Kellgren-Lawrence 分级相关（P<0.05）。
内侧半月板后角合并根韧带撕裂的拔出失效强度测量显示出一定的可修复性。MRI 上内侧半月板后角的退变程度与拔出失效强度显著相关。拔出失效强度不仅与内侧半月板后角的退变程度相关，还与代表骨退行性改变的机械对线和 Kellgren-Lawrence 分级相关。
