半月板修复术后半月板囊肿的发生率及相关危险因素。
Incidence and Risk Factors for Meniscal Cyst After Meniscal Repair.
机构信息
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
Arthroscopy. 2019 Apr;35(4):1222-1229. doi: 10.1016/j.arthro.2018.11.039. Epub 2019 Mar 11.
PURPOSE
To investigate the incidence of magnetic resonance imaging-confirmed cyst formation after meniscal repair and to analyze associated risk factors.
METHODS
This retrospective study included cases repaired arthroscopically with the all-inside (AI) technique (using suture anchors) and/or the inside-out (IO) technique between October 2008 and December 2014. A meniscal cyst was detected on T2 fat-suppressed magnetic resonance images. All cases were divided into 3 groups according to the repair method (AI, IO, and combined technique). The incidence of radiographically confirmed meniscal cyst formation in each group and the associated risk factors (age, sex, AI device, medial meniscus, Tegner activity scale preinjury) were analyzed.
RESULTS
A total of 102 menisci in 96 knees were evaluated. The mean follow-up period was 3.8 (range, 2-8) years. The mean patient age was 21.0 (range, 6-53) years. Thirty cases were in the AI group, 60 in the IO group, and 12 in the combined group. Demographically, there were significant differences among groups regarding the number of medial, lateral, and discoid tears; concomitant anterior cruciate ligament tears; Tegner scale; and suture number. Meniscal cysts developed in 14 of 102 cases. Two of the 14 cysts were symptomatic, requiring open cystectomy. The incidence of meniscal cyst was significantly higher in the AI group (12 of 30, 40%) than in the IO group (1 of 60, 1.7%) or the combined-technique group (1 of 12, 8.3%) (P < .001). Both symptomatic cysts were in the AI group and were in continuity with the anchors. Medial meniscus tear (odds ratio = 6.92) and the use of AI suture anchors (odds ratio = 15.03) significantly increased the risk of cyst formation.
CONCLUSIONS
The incidence of meniscal cysts after arthroscopic meniscal repair was 1.7% to 40.0%, depending on the surgical method. Medial meniscus tears and use of an AI device are suggested as risk factors for cyst formation in this retrospective study.
LEVEL OF EVIDENCE
Level Ⅲ, retrospective comparative study.
目的
研究半月板修复术后磁共振成像（MRI）确认的囊肿形成的发生率，并分析相关的危险因素。
方法
本回顾性研究纳入了 2008 年 10 月至 2014 年 12 月间接受关节镜下全内（AI）技术（使用缝合锚钉）和/或内-外（IO）技术修复的病例。在 T2 脂肪抑制 MRI 图像上发现半月板囊肿。根据修复方法（AI、IO 和联合技术）将所有病例分为 3 组。分析各组中影像学证实的半月板囊肿形成的发生率及相关危险因素（年龄、性别、AI 装置、内侧半月板、损伤前 Tegner 活动量表）。
结果
共评估了 96 个膝关节的 102 个半月板。平均随访时间为 3.8（2-8）年。平均患者年龄为 21.0（6-53）岁。30 例为 AI 组，60 例为 IO 组，12 例为联合组。在性别、内侧、外侧和盘状撕裂的数量、合并前交叉韧带撕裂、Tegner 量表和缝线数量方面，各组之间存在显著差异。102 例中有 14 例出现半月板囊肿。14 个囊肿中有 2 个有症状，需要行开放性囊肿切除术。AI 组（30 例中的 12 例，40%）的半月板囊肿发生率明显高于 IO 组（60 例中的 1 例，1.7%）或联合技术组（12 例中的 1 例，8.3%）（P<0.001）。2 个有症状的囊肿均在 AI 组，与锚钉相连。内侧半月板撕裂（比值比=6.92）和 AI 缝线锚钉的使用（比值比=15.03）显著增加了囊肿形成的风险。
结论
根据手术方法的不同，关节镜下半月板修复术后半月板囊肿的发生率为 1.7%至 40.0%。本回顾性研究提示，内侧半月板撕裂和使用 AI 装置是囊肿形成的危险因素。
证据等级
Ⅲ级，回顾性比较研究。
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