Vermesan D, Prejbeanu R, Laitin S, Georgianu V, Haragus H, Nitescu S, Tatullo M, Tattoli M, Caprio M, Cagiano R
University of Medicine and Pharmacy 'Victor Babes', Timisoara, Romania.
Eur Rev Med Pharmacol Sci. 2014;18(2):252-6.
Anterior cruciate ligament (ACL) injuries are a common finding in sports medicine. Our scope is to investigate whether stable, incomplete medial meniscus tears could be left untreated during single bundle anatomic anterior cruciate ligament reconstruction.
A prospective observational study on 597 knees from a single surgeon cohort, using the same reconstruction technique, found 23 medial and 48 lateral meniscus tears which could be left untreated.
None of the cases required reintervention during the first postoperative year. In fact, 21.7% of the medial meniscus group and 14.6% of the lateral group had potential residual symptoms that were not confirmed and gradually disappeared within one year. A comparison of Cincinnati Knee, IKDC scores and limb symmetry index values (calculated using the triple hop for distance into the two groups) found no differences for the last two variables (both p = 0.065) and was marginal for the first score (p < 0.05). The between groups comparisons, performed in the KT-1000, also yielded no difference (p = 0.11).
We than concluded that incomplete meniscal tears, left in situ at the time of anterior cruciate ligament reconstruction, could have favorable outcomes as long as decisions are carefully weighed with regard to the length of the lesion. Also, at least in this perspective, anatomic single bundle has proved a sufficient stabilizer for anterior translation of the tibia.
前交叉韧带(ACL)损伤在运动医学中很常见。我们的研究范围是调查在单束解剖重建前交叉韧带时,稳定的、不完全的内侧半月板撕裂是否可以不进行治疗。
对来自同一外科医生队列的597个膝关节进行前瞻性观察研究,采用相同的重建技术,发现23例内侧半月板撕裂和48例外侧半月板撕裂可以不进行治疗。
在术后第一年,所有病例均无需再次干预。事实上,内侧半月板组21.7%的患者和外侧半月板组14.6%的患者有潜在的残留症状,但未得到证实,并在一年内逐渐消失。比较辛辛那提膝关节评分、IKDC评分和肢体对称指数值(通过两组之间的三级跳远计算得出),发现后两个变量无差异(p = 0.065),第一个评分差异不显著(p < 0.05)。在KT-1000中进行的组间比较也没有差异(p = 0.11)。
我们随后得出结论,在前交叉韧带重建时原位保留的不完全半月板撕裂,只要对损伤长度进行仔细权衡,可能会有良好的结果。此外,至少从这个角度来看,解剖单束已被证明是胫骨前向平移的足够稳定器。