Furumatsu Takayuki, Okazaki Yuki, Kodama Yuya, Okazaki Yoshiki, Masuda Shin, Kamatsuki Yusuke, Takihira Shota, Hiranaka Takaaki, Yamawaki Tadashi, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan.
Department of Orthopaedic Surgery, Okayama University Hospital, Okayama, Japan.
Knee. 2019 Jun;26(3):653-659. doi: 10.1016/j.knee.2019.02.007. Epub 2019 Mar 20.
Pullout repairs of medial meniscus posterior root tears (MMPRTs) have many surgical options. However, there has been no reliable clinical study conducted to compare the superiority of each pullout repair technique. The current study hypothesized that pullout repairs using a modified Mason-Allen suture with FasT-Fix (F-MMA) would have several advantages in postoperative clinical outcomes and meniscal healing compared with single FasT-Fix. The aim of this study was to investigate the clinical usefulness of these two techniques in treating MMPRTs.
Thirty-eight patients who had complete MMPRTs were included. All patients underwent transtibial pullout repairs. To compare the clinical usefulness between pullout repairs using single FasT-Fix and F-MMA techniques, patients were divided into two groups. Second-look arthroscopic evaluations of meniscal healing were performed at one year postoperatively. Clinical outcomes were assessed using: Lysholm and visual analogue scale (VAS) pain scores, and Knee Injury and Osteoarthritis Outcome Score (KOOS).
Single FasT-Fix and F-MMA pullout repairs improved clinical outcomes in patients with MMPRTs. At second-look arthroscopy, VAS pain, KOOS pain, and arthroscopic meniscal healing scores following F-MMA pullout repairs were superior to those after single FasT-Fix pullout repairs.
This study demonstrated that F-MMA suture configuration obtained better meniscal healing and superior clinical outcomes compared with single FasT-Fix repairs in patients with MMPRTs. These results suggest that the F-MMA pullout repair may possibly reduce knee pain in arthroscopic treatments of MMPRTs.
内侧半月板后根撕裂(MMPRT)的拔出修复有多种手术选择。然而,尚未进行可靠的临床研究来比较每种拔出修复技术的优越性。本研究假设,与单纯使用FasT-Fix相比,使用改良的Mason-Allen缝线联合FasT-Fix(F-MMA)进行拔出修复在术后临床结果和半月板愈合方面具有若干优势。本研究的目的是探讨这两种技术在治疗MMPRT中的临床实用性。
纳入38例患有完全性MMPRT的患者。所有患者均接受经胫骨拔出修复。为了比较单纯使用FasT-Fix和F-MMA技术进行拔出修复的临床实用性,将患者分为两组。术后一年进行二次关节镜检查以评估半月板愈合情况。使用Lysholm评分、视觉模拟量表(VAS)疼痛评分以及膝关节损伤和骨关节炎疗效评分(KOOS)来评估临床结果。
单纯使用FasT-Fix和F-MMA拔出修复均改善了MMPRT患者的临床结果。在二次关节镜检查时,F-MMA拔出修复后的VAS疼痛评分、KOOS疼痛评分和关节镜下半月板愈合评分均优于单纯使用FasT-Fix拔出修复后的评分。
本研究表明,在患有MMPRT的患者中,与单纯使用FasT-Fix修复相比,F-MMA缝线构型在半月板愈合方面效果更好,临床结果更优。这些结果表明,在关节镜治疗MMPRT时,F-MMA拔出修复可能会减轻膝关节疼痛。