Rush University Medical Center, Chicago, IL, USA.
Georgetown University School of Medicine, Washington, DC, USA.
Cartilage. 2020 Jan;11(1):77-87. doi: 10.1177/1947603518783473. Epub 2018 Jun 29.
To define patient demographics, preoperative, and intraoperative surgical variables associated with successful or failed repair of bucket-handle meniscal tears.
All patients who underwent arthroscopic repair of a bucket-handle meniscus tear at a single institution between May 2011 and July 2016 with minimum 6-month follow-up were retrospectively identified. Patient demographic, preoperative (including imaging), and operative variables were collected and evaluated. A Kaplan-Meier curve was generated to demonstrate meniscus repair survivorship.
In total, 75 patients (78 knees) with an average age of 26.53 ± 10.67 years met inclusion criteria. The average follow-up was 23.41 ± 16.43 months. Fifteen knees (19.2%) suffered re-tear of the repaired meniscus at an average 12.24 ± 9.50 months postoperatively. Survival analysis demonstrated 93.6% survival at 6 months, 84.6% survival at 1 year, 78.4% survival at 2 years, and 69.9% survival at 3 years. There was significant improvement from baseline to time of final follow-up in all patient-reported outcome ( < 0.05) except Marx score ( = 0.933) and SF-12 Mental Subscale ( = 0.807). The absence of other knee pathology (including ligament tear, contralateral compartment meniscal tear, or cartilage lesions) noted intraoperatively was the only variable significantly associated with repair failure ( = 0.024). Concurrent anterior cruciate ligament reconstruction (vs. no concurrent anterior cruciate ligament reconstruction) trended toward significance ( = 0.059) as a factor associated with successful repair.
With the exception of the absence of other knee pathology (including ligament tear, contralateral compartment meniscal tear, or cartilage lesions) noted intraoperatively, no other variables were significantly associated with re-tear. The results are relatively durable with 84.6% survival at 1 year. Surgeons should attempt meniscal repair when presented with a bucket-handle tear.
确定与成功或失败修复桶柄状半月板撕裂相关的患者人口统计学、术前和术中手术变量。
回顾性分析 2011 年 5 月至 2016 年 7 月期间在一家医疗机构接受关节镜下桶柄状半月板撕裂修复的所有患者，随访时间至少为 6 个月。收集并评估患者的人口统计学、术前（包括影像学）和手术变量。生成 Kaplan-Meier 曲线以显示半月板修复的存活率。
共有 75 名（78 膝）平均年龄为 26.53 ± 10.67 岁的患者符合纳入标准。平均随访时间为 23.41 ± 16.43 个月。15 膝（19.2%）在术后平均 12.24 ± 9.50 个月时出现修复半月板再撕裂。生存分析显示 6 个月时存活率为 93.6%，1 年时存活率为 84.6%，2 年时存活率为 78.4%，3 年时存活率为 69.9%。除 Marx 评分（=0.933）和 SF-12 精神分量表（=0.807）外，所有患者报告的结果均从基线到最终随访时均有显著改善（<0.05）。术中发现无其他膝关节病变（包括韧带撕裂、对侧间室半月板撕裂或软骨病变）是与修复失败显著相关的唯一变量（=0.024）。同期行前交叉韧带重建术（与同期未行前交叉韧带重建术相比）与成功修复呈显著相关趋势（=0.059）。
除术中发现无其他膝关节病变（包括韧带撕裂、对侧间室半月板撕裂或软骨病变）外，没有其他变量与再撕裂显著相关。术后 1 年的存活率为 84.6%，结果相对持久。当遇到桶柄状撕裂时，外科医生应尝试进行半月板修复。
