Matsushita Takehiko, Nagai Kanto, Araki Daisuke, Tanaka Toshikazu, Matsumoto Tomoyuki, Nishida Kotaro, Kurosaka Masahiro, Kuroda Ryosuke
a Department of Orthopaedic Surgery , Kobe University Graduate School of Medicine , Kobe , Japan.
Connect Tissue Res. 2017 May-Jul;58(3-4):386-392. doi: 10.1080/03008207.2017.1281257. Epub 2017 Jan 19.
Anterior cruciate ligament (ACL) injuries are often accompanied by meniscal tears. Meniscal repair is typically performed during ACL reconstruction. However, retear of the meniscus after repair is frequent. The purpose of this study was to analyze the factors associated with meniscal healing after meniscal repair concomitant with ACL reconstruction.
Eighty-seven meniscal repairs in 87 patients who received meniscal repair combined with ACL reconstruction and received second-look arthroscopy at a mean of postoperatively 15.7 months were examined retrospectively. The menisci were divided into three groups (complete heal, incomplete heal, and retear), and factors thought to affect the healing status of repaired menisci were analyzed using multivariate logistic regression analysis.
Meniscal healing was judged to be complete in 49 knees (56%), incomplete in 19 knees, (22%), and retear in 19 knees (22%). There were no significant differences among the three groups in age, sex, time from injury to operation, mean Tegner activity scale, tear location, or mean postoperative anteroposterior tibial translation on KT-1000. The mean length of the tear was significantly higher in the retear group. Additionally, the proportion patients with complete tear and the proportion with postoperative positive pivot shift test were significantly higher in the retear group than in the other groups. Multivariate logistic regression analysis showed that complete tear and positive pivot shift test were associated with retear.
These findings suggest that complete tears and residual instability are associated with retears after meniscal repair concomitant with ACL reconstruction.
前交叉韧带（ACL）损伤常伴有半月板撕裂。半月板修复通常在ACL重建时进行。然而，半月板修复后再撕裂很常见。本研究的目的是分析与ACL重建同时进行半月板修复后半月板愈合相关的因素。
回顾性研究87例接受半月板修复联合ACL重建且平均在术后15.7个月接受二次关节镜检查的患者的87例半月板修复情况。将半月板分为三组（完全愈合、不完全愈合和再撕裂），并使用多因素逻辑回归分析来分析被认为会影响修复半月板愈合状态的因素。
49个膝关节（56%）的半月板愈合被判定为完全愈合，19个膝关节（22%）为不完全愈合，19个膝关节（22%）为再撕裂。三组在年龄、性别、受伤至手术的时间、平均Tegner活动量表评分、撕裂部位或KT-1000测量的术后胫骨前后平移平均值方面无显著差异。再撕裂组的平均撕裂长度显著更高。此外，再撕裂组完全撕裂患者的比例和术后阳性轴移试验患者的比例显著高于其他组。多因素逻辑回归分析表明，完全撕裂和阳性轴移试验与再撕裂有关。
这些发现表明，完全撕裂和残留不稳定与ACL重建同时进行半月板修复后的再撕裂有关。
