Ulku Tekin Kerem, Kaya Alper, Kocaoglu Baris
Acibadem University Faculty of Medicine, Department of Orthopedic Surgery, Acibadem Altunizade Hospital, Turkey.
Acibadem University Faculty of Medicine, Department of Orthopedic Surgery, Acibadem Altunizade Hospital, Turkey.
Knee. 2020 Jun;27(3):676-682. doi: 10.1016/j.knee.2020.04.017. Epub 2020 Apr 30.
The aim of this study was to evaluate the clinical and radiological outcomes of arthroscopic transtibial pullout repair (ATPR) for the medial meniscus with both two modified loop stitches (TLS) and two simple stitches (TSS) techniques.
Between January 2013 and January 2016, 41 patients who had undergone ATPR for medial root tears with TLS and TSS techniques were retrospectively evaluated. The mean age at operation was 53 years (range 45-58). The mean follow-up period was 44.6 months (range 26-64). Lysholm knee score was used for clinical evaluation before and after surgery. For all patients, meniscal extrusion distances in the coronal plane were measured using magnetic resonance imaging and were recorded both preoperatively and at final follow-up.
There was no difference in terms of meniscus extrusion measurements between groups preoperatively (P > .05). Postoperative meniscus extrusion measurements were 2.1 ± 0.3 and 2.9 ± 0.6 in TLS and TSS groups, respectively. The difference between groups was statistically significant (P < .01). The increase in postoperative Lysholm score was found to be statistically significant in both groups (P < .01). Postoperative Lysholm scores were 88.8 ± 3.7 and 87.6 ± 4.8 in TLS and TSS groups, respectively. The difference between groups was statistically insignificant (P > .05).
There was a significant improvement in Lysholm knee scores postoperatively in patients that underwent transtibial pullout medial meniscus posterior root repair regardless of meniscus reduction level and suture configuration types. Although TLS technique was superior to TSS technique in terms of meniscus reduction, this meniscus reduction did not create any clinical difference at clinical outcome.
本研究的目的是评估采用两种改良环缝法(TLS)和两种简单缝合法(TSS)技术进行关节镜下经胫骨拉出修复术(ATPR)治疗内侧半月板的临床和影像学结果。
回顾性评估2013年1月至2016年1月期间41例行TLS和TSS技术经胫骨拉出修复术治疗内侧半月板根部撕裂的患者。手术时的平均年龄为53岁(范围45 - 58岁)。平均随访期为44.6个月(范围26 - 64个月)。采用Lysholm膝关节评分对手术前后进行临床评估。对所有患者,术前和末次随访时均使用磁共振成像测量冠状面半月板挤出距离并记录。
术前两组间半月板挤出测量值无差异(P > 0.05)。TLS组和TSS组术后半月板挤出测量值分别为2.1±0.3和2.9±0.6。两组间差异有统计学意义(P <0.01)。两组术后Lysholm评分增加均有统计学意义(P <0.01)。TLS组和TSS组术后Lysholm评分分别为88.8±3.7和87.6±4.8。两组间差异无统计学意义(P > 0.05)。
无论半月板复位水平和缝线构型类型如何,经胫骨拉出内侧半月板后根修复术后患者的Lysholm膝关节评分均有显著改善。虽然在半月板复位方面TLS技术优于TSS技术,但这种半月板复位在临床结果上并未产生任何临床差异。