Furumatsu Takayuki, Kodama Yuya, Kamatsuki Yusuke, Hino Tomohito, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,
Acta Med Okayama. 2017 Oct;71(5):413-418. doi: 10.18926/AMO/55439.
Extrusion of the medial meniscus (MM) is associated with knee joint pain in osteoarthritic knees. The relationships among MM radial/oblique tears, MM extrusion (MME), and the effect of arthroscopic meniscal repair are not established. Here we evaluated the effects of arthroscopic all-inside MM repair on MME and the clinical outcomes in patients with radially oriented MM tears and mildly osteoarthritic knees. Twenty patients with a symptomatic radial or oblique tear of the MM posterior segment, MME ≥2.5 mm, and mildly osteoarthritic knees were treated using FasT-Fix 360 All-inside Meniscal Suture devices. We used magnetic resonance imaging (MRI) to measure the patients' MM body width (MMBW), absolute MME, and relative MME. The Japanese Knee Injury and Osteoarthritis Outcome Score, Lysholm, Tegner, IKDC Subjective Knee Evaluation, and Visual Analogue Scale scores were obtained. Arthroscopic all-inside MM repair prevented increases of absolute and relative MME. The preoperative and 3- and 12-month MRI-based MMBW values were similar. Over a 24-month follow-up after the MM repairs, the clinical scores showed significant improvements. Our results suggest that all-inside meniscal repairs would be useful in preventing the progression of MME in patients suffering from symptomatic MM radial/oblique tears associated with mildly osteoarthritic knees.
内侧半月板(MM)挤出与骨关节炎膝关节的疼痛相关。MM 放射状/斜形撕裂、MM 挤出(MME)以及关节镜下半月板修复效果之间的关系尚未明确。在此,我们评估了关节镜下全内 MM 修复对 MME 的影响以及对有放射状 MM 撕裂和轻度骨关节炎膝关节患者的临床疗效。20 例有症状的 MM 后段放射状或斜形撕裂、MME≥2.5mm 且膝关节轻度骨关节炎的患者使用 FasT-Fix 360 全内半月板缝合装置进行治疗。我们使用磁共振成像(MRI)测量患者的 MM 体部宽度(MMBW)、绝对 MME 和相对 MME。获取日本膝关节损伤和骨关节炎疗效评分、Lysholm 评分、Tegner 评分、IKDC 主观膝关节评估以及视觉模拟量表评分。关节镜下全内 MM 修复可防止绝对和相对 MME 增加。术前以及术后 3 个月和 12 个月基于 MRI 的 MMBW 值相似。在 MM 修复后的 24 个月随访中,临床评分显示有显著改善。我们的结果表明,全内半月板修复对于预防有症状的与轻度骨关节炎膝关节相关的 MM 放射状/斜形撕裂患者的 MME 进展可能是有用的。