Hiranaka Takaaki, Furumatsu Takayuki, Masuda Shin, Okazaki Yoshiki, Okazaki Yuki, Kodama Yuya, Kamatsuki Yusuke, Kajiki Yuya, Zhang Ximing, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Eur J Orthop Surg Traumatol. 2020 Jul;30(5):901-908. doi: 10.1007/s00590-020-02647-w. Epub 2020 Mar 10.
Two types of repair techniques, FasT-Fix modified Mason-Allen (F-MMA) and two simple stitches (TSS), for the treatment of a medial meniscus posterior root tear (MMPRT) were previously reported. However, whether these techniques could prevent postoperative medial meniscus extrusion (MME) progression is unknown. This study investigated and compared postoperative MME of the two repair techniques.
Forty-seven knees that had undergone pullout repair for MMPRT were retrospectively reviewed. These knees were divided into two groups as follows: In 26 knees, MMPRT was treated using the F-MMA technique and fixed with the knee flexed at 45° and 20 N of tension [F-MMA (45°-20 N) group], and in 21 knees, MMPRT was treated using the TSS technique and fixed with the knee flexed at 20° and 30 N of tension [TSS (20°-30 N) group]. The medial meniscus body width (MMBW), absolute MME (aMME), and relative MME (rMME = absolute MME/MMBW) were measured and compared using magnetic resonance imaging 3 months postoperatively. The Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales for clinical outcomes were compared between the two groups at 6 months postoperatively.
At 3 months postoperatively, the aMME and rMME significantly decreased in the TSS (20°-30 N) compared to the F-MMA (45°-20 N) group. The TSS (20°-30 N) group had better KOOS subscale scores than the F-MMA (45°-20 N) group at 6 months postoperatively.
The TSS technique with appropriate tibial fixation can decrease MME soon after surgery. This may prevent osteoarthritis progression and improve clinical outcomes.
先前报道了两种用于治疗内侧半月板后根撕裂(MMPRT)的修复技术,即改良的FasT-Fix Mason-Allen(F-MMA)和两种简单缝线(TSS)。然而,这些技术能否预防术后内侧半月板挤出(MME)进展尚不清楚。本研究调查并比较了两种修复技术的术后MME情况。
回顾性分析47例行MMPRT拉出修复术的膝关节。这些膝关节分为两组:26例膝关节采用F-MMA技术治疗,在膝关节屈曲45°、张力20 N的情况下固定[F-MMA(45°-20 N)组];21例膝关节采用TSS技术治疗,在膝关节屈曲20°、张力30 N的情况下固定[TSS(20°-30 N)组]。术后3个月使用磁共振成像测量并比较内侧半月板体部宽度(MMBW)、绝对MME(aMME)和相对MME(rMME =绝对MME/MMBW)。术后6个月比较两组临床结果的膝关节损伤和骨关节炎疗效评分(KOOS)子量表。
术后3个月,与F-MMA(45°-20 N)组相比,TSS(20°-30 N)组的aMME和rMME显著降低。术后6个月,TSS(20°-30 N)组的KOOS子量表评分优于F-MMA((45°-20 N)组。
采用适当胫骨固定的TSS技术可在术后早期减少MME。这可能预防骨关节炎进展并改善临床结果。