Liao Weixiong, Li Zhongli, Zhang Hao, Li Ji, Wang Ketao, Yang Yimeng
Department of Orthopedics, General Hospital of PLA, Beijing, China.
Department of Orthopedics, General Hospital of PLA, Beijing, China.
Arthroscopy. 2016 Aug;32(8):1639-50. doi: 10.1016/j.arthro.2016.01.032. Epub 2016 Apr 1.
To compare clinical outcomes of arthroscopic therapy for tibial eminence fracture with nonabsorbable suture and absorbable suture anchor.
Between February 2010 and September 2012, a total of 60 tibial eminence fracture patients were treated with nonabsorbable suture fixation or absorbable suture anchor fixation under arthroscopy. Patients with tibial plateau fractures and other significant injuries, including osteochondral lesions, meniscal tear, and anterior cruciate ligament (ACL) or mutiligament injuries, were excluded from the study. Radiographs, anterior drawer test (ADT), Lachman test, Lysholm score, and International Knee Documentation Committee (IKDC) 2000 subjective score were employed to evaluate clinical outcomes in follow-up.
A total of 41 patients were analyzed. Among these patients, 22 were treated with nonabsorbable suture fixation and 19 with absorbable suture anchor fixation. According to the modified Meyers-McKeever classification, 15 cases were categorized as type II, 21 as type III, and 5 as type IV fractures. The mean time from injury to surgery was 7.1 days (range, 3 to 12 days). All patients were followed up for a median period of 33.7 months (range, 24 to 45 months). Radiographic evaluation showed optimal reduction immediately after operation and bone union within 3 months in all patients. At the final follow-up, there was no limitation of knee motion range in any patient. Grade II laxity was found in 2 cases from suture group and 1 from suture anchor group, showing no significant difference based on ADT (χ(2) = 0.538, P = .764) and Lachman test (χ(2) = 0.550, P = .760). Lysholm and IKDC 2000 subjective scores were significantly improved (P < .001). However, there were no significant differences in the improvement of Lysholm (t = 0.522, P = .604) and IKDC 2000 subjective scores (t = 0.644, P = .523) between the 2 groups.
Nonabsorbable suture fixation and absorbable suture anchor fixation are equivalent techniques in terms of the clinical efficacy of arthroscopic tibial eminence fracture treatment.
Level III, retrospective comparative study.
比较采用不可吸收缝线和可吸收缝线锚钉进行关节镜治疗胫骨髁间棘骨折的临床疗效。
2010年2月至2012年9月期间，共有60例胫骨髁间棘骨折患者在关节镜下接受不可吸收缝线固定或可吸收缝线锚钉固定治疗。排除合并胫骨平台骨折及其他严重损伤（包括骨软骨损伤、半月板撕裂、前交叉韧带或多韧带损伤）的患者。采用X线片、前抽屉试验（ADT）、Lachman试验、Lysholm评分及国际膝关节文献委员会（IKDC）2000主观评分对随访时的临床疗效进行评估。
共分析41例患者。其中，22例接受不可吸收缝线固定治疗，19例接受可吸收缝线锚钉固定治疗。根据改良的Meyers-McKeever分型，15例为Ⅱ型，21例为Ⅲ型，5例为Ⅳ型骨折。受伤至手术的平均时间为7.1天（范围3至12天）。所有患者随访时间中位数为33.7个月（范围24至45个月）。影像学评估显示所有患者术后即刻复位良好，3个月内均达到骨愈合。末次随访时，所有患者膝关节活动范围均无受限。缝线组2例、缝线锚钉组1例出现Ⅱ级松弛，基于ADT（χ(2)=0.538，P=.764）和Lachman试验（χ(2)=0.550，P=.760）结果显示差异无统计学意义。Lysholm评分和IKDC 2000主观评分均显著改善（P<.001）。然而，两组间Lysholm评分改善情况（t=0.522，P=.604）及IKDC 2000主观评分改善情况（t=0.644，P=.523）差异均无统计学意义。
在关节镜治疗胫骨髁间棘骨折的临床疗效方面，不可吸收缝线固定和可吸收缝线锚钉固定技术相当。
Ⅲ级，回顾性比较研究。
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