Unidad de Cirugía Artroscópica, Departamento de COT, Hospital Ramón y Cajal, Cta Colmenar Km 9.100, Madrid 28034, Spain.
Am J Sports Med. 2012 Oct;40(10):2289-95. doi: 10.1177/0363546512457552. Epub 2012 Sep 7.
Tibial plateau fractures are frequently associated with meniscal tears. Little is known about the results of meniscal repair in this group of patients.
To determine the results of repair of meniscal tears found during arthroscopically assisted reduction and internal fixation (ARIF) of tibial plateau fractures.
Case series; Level of evidence, 4.
In a cohort of 51 tibial plateau fractures treated with ARIF, 15 associated meniscal tears (15 knees) in 14 patients were repaired. There were 12 peripheral longitudinal tears of the lateral meniscus, 1 longitudinal peripheral tear of the medial meniscus, 1 full-thickness radial tear of the lateral meniscus, and 1 bird-beak tear of the lateral meniscus. Repairs were performed using an outside-in technique for the anterior horn and all-inside repair for the body and posterior horn lesions. Mean (SD) age at operation was 47.3 (14.0) years. Patients were followed for a mean (SD) of 4.83 (1.01) years and evaluated using the Rasmussen, Honkonen, Lysholm, Tegner, and International Knee Documentation Committee (IKDC) scores. A second-look arthroscopy was performed in 13 knees a mean (SD) of 14.2 (10.1) months after the initial surgery.
The mean (SD) Rasmussen score was 29.1 (0.96). Thirteen of 15 patients scored good or excellent results in all Honkonen sections. The mean (SD) Lysholm score was 88.6 (12.4). The mean (SD) IKDC score was 79.3 (19.3). There was a small decrease of the activity level according to the Tegner score when compared with the preoperative situation (1.20 [1.82], P = .022). There were not any meniscal symptoms in any case. Of the 13 menisci evaluated with second-look arthroscopy, 12 had healed completely and a radial tear had healed partially in the vascular zone. In one of the cases that healed, a new tear was found in a different location.
Meniscal repair of tears associated with tibial plateau fractures has good results. All patients had good or excellent clinical results. Second-look arthroscopy confirmed complete healing in 92% of meniscal tears when performed.
胫骨平台骨折常伴有半月板撕裂。对于关节镜辅助复位内固定（ARIF）治疗胫骨平台骨折患者的半月板修复结果知之甚少。
确定关节镜辅助复位内固定（ARIF）治疗胫骨平台骨折时发现的半月板撕裂的修复结果。
病例系列；证据水平，4 级。
在接受 ARIF 治疗的 51 例胫骨平台骨折患者中，14 例患者的 15 个膝关节存在 15 个半月板撕裂（15 个膝关节）。其中 12 例为外侧半月板前角外周纵行撕裂，1 例为内侧半月板后角纵行撕裂，1 例为外侧半月板全层放射状撕裂，1 例为外侧半月板鸟嘴状撕裂。前角采用经皮入路技术修复，体部和后角采用全内技术修复。手术时的平均（标准差）年龄为 47.3（14.0）岁。患者平均（标准差）随访 4.83（1.01）年，采用 Rasmussen、Honkonen、Lysholm、Tegner 和国际膝关节文献委员会（IKDC）评分进行评估。初次手术后平均（标准差）14.2（10.1）个月时，对 13 个膝关节进行了二次关节镜检查。
平均（标准差）Rasmussen 评分为 29.1（0.96）。15 例患者中有 13 例在所有 Honkonen 节段的评分均为良好或优秀。平均（标准差）Lysholm 评分为 88.6（12.4）。平均（标准差）IKDC 评分为 79.3（19.3）。与术前相比，Tegner 评分的活动水平略有下降（1.20[1.82]，P=.022）。在任何情况下均无半月板症状。在接受二次关节镜检查的 13 个半月板中，12 个完全愈合，一个在血管区的放射状撕裂部分愈合。在愈合的 1 例中，在不同部位发现了新的撕裂。
胫骨平台骨折合并半月板撕裂的半月板修复效果良好。所有患者均获得良好或优秀的临床结果。当进行二次关节镜检查时，92%的半月板撕裂完全愈合。
