Zheng Jiapeng, Zhai Wenliang, Li Qiang, Jia Qianxin, Lin Dasheng
Department of Orthopaedic Surgery, the Affiliated Southeast Hospital of Xiamen University, Zhangzhou, China.
Department of Radiology, the Affiliated Southeast Hospital of Xiamen University, Zhangzhou, China.
PLoS One. 2017 Jan 26;12(1):e0170710. doi: 10.1371/journal.pone.0170710. eCollection 2017.
We describe a special, interesting phenomenon found in the anterior horn of the lateral meniscus (AHLM): most tear patterns in the AHLM are distinctive, with loose fibers in injured region and circumferential fiber bundles were separated. We name it as macerated tear. The goal of this study was to bring forward a new type of meniscal tear in the AHLM and investigate its clinical value.
AHLM tears underwent arthroscopic surgery from January 2012 to December 2014 were included. Data regarding the integrity of AHLM were prospectively recorded in a data registry. Tear morphology and treatment received were subsequently extracted by 2 independent reviewers from operative notes and arthroscopic surgical photos.
A total of 60 AHLM tears in 60 patients (mean age 27.1 years) were grouped into horizontal tears (n = 15, 25%), vertical tears (n = 14, 23%), complex tears (n = 6, 10%), and macerated tears (n = 25, 42%). There were 6 patients with AHLM cysts in macerated tear group and one patient in vertical tear group. 60 patients were performed arthroscopic meniscus repairs and were followed-up with averaged 18.7 months. Each group had significant postoperative improvement in Lysholm and IKDC scores (p < 0.05). However, the macerated tear group showed least functional recovery of Lysholm and IKDC scores compared to other groups (p < 0.05). In addition, there were no differences in postoperative range of motion, return to work, or return to sport/other baseline activities between the four groups (p > 0.05).
This study demonstrated that the macerated tear is common in the tear pattern of AHLM. However, feasibility of the treatment of this type of meniscal tear, especially the meniscus repairs still requires further study.
我们描述了在外侧半月板前角（AHLM）发现的一种特殊且有趣的现象：AHLM中的大多数撕裂模式都很独特，损伤区域的纤维松散，圆周纤维束分离。我们将其命名为浸软撕裂。本研究的目的是提出一种AHLM新型半月板撕裂，并探讨其临床价值。
纳入2012年1月至2014年12月接受关节镜手术的AHLM撕裂患者。关于AHLM完整性的数据前瞻性记录在数据登记处。随后由2名独立审阅者从手术记录和关节镜手术照片中提取撕裂形态和接受的治疗。
60例患者（平均年龄27.1岁）的60处AHLM撕裂被分为水平撕裂（n = 15, 25%）、垂直撕裂（n = 14, 23%）、复合撕裂（n = 6, 10%）和浸软撕裂（n = 25, 42%）。浸软撕裂组有6例患者伴有AHLM囊肿，垂直撕裂组有1例患者伴有。60例患者接受了关节镜半月板修复，并平均随访18.7个月。每组术后Lysholm和IKDC评分均有显著改善（p < 0.05）。然而，与其他组相比，浸软撕裂组的Lysholm和IKDC评分功能恢复最少（p < 0.05）。此外，四组之间术后活动范围、恢复工作或恢复运动/其他基线活动方面无差异（p > 0.05）。
本研究表明浸软撕裂在AHLM撕裂模式中很常见。然而，这种类型半月板撕裂的治疗可行性，尤其是半月板修复仍需要进一步研究。
