Department of Orthopedics and Traumatology, Acibadem Kadikoy Hospital, Istanbul, Turkey.
Am J Sports Med. 2013 Mar;41(3):596-602. doi: 10.1177/0363546512472046. Epub 2013 Jan 22.
Although numerous studies have assessed arthroscopic repair of meniscal tears, no study has described the repair of partial- or full-thickness longitudinal medial meniscal tears using single or double vertical sutures.
To present the intermediate-term results of medial meniscal tears repaired with single or double vertical sutures.
Case series; Level of evidence, 4.
The authors evaluated the results of 112 longitudinal medial meniscal tears treated with inside-out single or double vertical sutures, with or without anterior cruciate ligament (ACL) reconstruction, based on the clinical resolution of symptoms, the Lysholm knee scoring scale, and the Tegner activity scale. Re-examination was also performed by magnetic resonance imaging after the repair. The length of the tears was evaluated arthroscopically. Eighty-five tears of 112 were >2 cm in length, and 27 were tears ≤2 cm. Eighty-nine (79.4%) of the 112 repairs were performed in conjunction with ACL reconstructions, and the remaining 23 (20.6%) repairs were performed in ACL-intact knees. The tear type of the menisci in our study was full thickness in 66 (58.9%) cases and partial thickness in 46 (41.1%) cases. Double vertical sutures were used for full-thickness tears, and single vertical sutures were used for partial-thickness tears.
The cases were evaluated after a mean follow-up duration of 49.3 months (range, 12-88 months). Clinical and radiological examination results determined that 99 (88.4%) meniscal repairs had healed, and the remaining 13 cases (10.6%) were considered to be failures. The healing rate of the full-thickness group was 80.3%, while in the partial-thickness group, the rate was 100%. The mean Lysholm score improved significantly from a preoperative value of 63.8 to a postoperative value of 89.5 (P < .001). The mean Tegner activity score was 3.3 preoperatively and 6.7 postoperatively (P < .001). Logistic regression analysis found that concurrent ACL reconstruction, tear length, and smoking as factors had a significant effect on meniscal healing.
Single or double vertical sutures using the inside-out technique provide a high rate of healing in longitudinal medial meniscal tears.
尽管已有大量研究评估了关节镜下半月板撕裂的修复，但尚无研究描述使用单根或双根垂直缝线修复部分或全层纵向内侧半月板撕裂。
介绍使用单根或双根垂直缝线修复内侧半月板撕裂的中期结果。
病例系列；证据水平，4 级。
作者根据症状缓解情况、Lysholm 膝关节评分和 Tegner 活动评分评估了 112 例接受关节镜下单根或双根垂直缝线修复的纵向内侧半月板撕裂的结果，其中包括或不包括前交叉韧带（ACL）重建。修复后还通过磁共振成像进行了复查。关节镜下评估撕裂的长度。112 例撕裂中，85 例>2 cm，27 例≤2 cm。89 例（79.4%）的修复与 ACL 重建同时进行，其余 23 例（20.6%）的修复在 ACL 完整的膝关节中进行。本研究中半月板的撕裂类型为全层撕裂 66 例（58.9%），部分层撕裂 46 例（41.1%）。全层撕裂采用双根垂直缝线，部分层撕裂采用单根垂直缝线。
平均随访时间为 49.3 个月（12-88 个月）后进行了病例评估。临床和影像学检查结果确定 99 例（88.4%）半月板修复愈合，其余 13 例（10.6%）为失败。全层组的愈合率为 80.3%，而部分层组为 100%。术前 Lysholm 评分平均为 63.8，术后为 89.5（P<.001），显著改善。术前 Tegner 活动评分平均为 3.3，术后为 6.7（P<.001）。Logistic 回归分析发现，同时进行 ACL 重建、撕裂长度和吸烟是影响半月板愈合的显著因素。
使用经皮内外技术的单根或双根垂直缝线可使纵向内侧半月板撕裂获得较高的愈合率。
