Keyhani Sohrab, Ahn Jin Hwan, Verdonk René, Soleymanha Mehran, Abbasian Mohammadreza
Orthopedic Department Chair, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):454-458. doi: 10.1007/s00167-016-4410-9. Epub 2016 Dec 27.
The purpose of this study was to evaluate and describe the clinical results and outcomes of a novel method for all-inside suture repair of medial meniscus ramp lesions through posteromedial and posterolateral transseptal portals during anterior cruciate ligament (ACL) reconstruction. Further, this investigation compared the posterolateral view to the notch view for diagnosis and repair.
Between 2011 and 2014, 166 patients had ramp lesions concomitantly with ACL injury; 128 patients (107 men and 21 women) were enrolled in the study after qualification. All patients underwent repair of the posterior horn ramp lesion of the medial meniscus, using a suture hook device with PDS No. 1 through a posteromedial portal while viewing from the posterolateral transseptal portal during ACL reconstruction, with a minimum of a 2-year follow-up.
Patients were followed up for a minimum of 2 years (range 24-47 months). Their average Lysholm score increased from 61.7 ± 3.2 preoperatively to 87.8 ± 3.9 at last follow-up (p < 0.001). Moreover, their average IKDC scores also improved from 53.6 ± 2.1 (pre-op) to 82.1 ± 3.5 (at last follow-up) (p < 0.001). The peroneal nerve and the popliteal neurovascular bundle were not damaged in any of the patients.
This study provides evidence that the posterolateral transseptal technique protects neurovascular structures. This technique may be used safely and easily for repair of the posterior horn ramp lesion of the medial meniscus during ACL reconstruction.
IV.
本研究旨在评估并描述一种在膝关节前交叉韧带（ACL）重建过程中，通过后内侧和后外侧经间隔入路对内侧半月板斜坡损伤进行全关节内缝合修复的新方法的临床效果和结局。此外，本研究还比较了后外侧视野与髁间切迹视野在诊断和修复中的差异。
2011年至2014年间，166例患者同时存在斜坡损伤和ACL损伤；128例患者（107例男性和21例女性）经筛选后纳入本研究。所有患者在ACL重建过程中，通过后内侧入路，使用1号聚对二氧环己酮（PDS）缝线钩装置，从后外侧经间隔入路观察，对内侧半月板后角斜坡损伤进行修复，随访时间至少为2年。
患者随访时间至少为2年（范围24 - 47个月）。他们的平均Lysholm评分从术前的61.7±3.2提高到末次随访时的87.8±3.9（p < 0.001）。此外，他们的平均国际膝关节文献委员会（IKDC）评分也从术前的53.6±2.1提高到末次随访时的82.1±3.5（p < 0.001）。所有患者均未出现腓总神经和腘血管神经束损伤。
本研究表明后外侧经间隔技术可保护神经血管结构。该技术可安全、简便地用于ACL重建过程中内侧半月板后角斜坡损伤的修复。
IV级。
