Hiranaka Takaaki, Furumatsu Takayuki, Miyazawa Shinichi, Okazaki Yoshiki, Okazaki Yuki, Takihira Shota, Kodama Yuya, Kamatsuki Yusuke, Masuda Shin, Saito Taichi, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama 700-8558, Japan.
Knee. 2020 Jun;27(3):701-708. doi: 10.1016/j.knee.2020.04.023. Epub 2020 May 11.
Transtibial pullout repair of a medial meniscus posterior root tear (MMPRT) is a commonly used procedure, and several techniques have been reported. We hypothesised that pull-out repairs using two simple stitches (TSS) would have similar postoperative outcomes as those using the modified Mason-Allen suture with FasT-Fix (F-MMA). We aimed to investigate the clinical outcomes of these techniques, including the meniscal healing status and osteoarthritic change.
The data of 68 patients who underwent transtibial pull-out repair were retrospectively investigated. The patients were divided into two groups of 41 and 27 patients using F-MMA and TSS, respectively. The clinical outcomes were assessed preoperatively and at second-look arthroscopy (the mean period from surgery was one year) using the Knee injury and Osteoarthritis Outcome Score. The meniscal healing status, evaluated at second-look arthroscopy, was compared between the two groups. The cartilage damage was graded as per the classification of the International Cartilage Repair Society and compared at the primary surgery and second-look arthroscopy.
Both groups showed significant improvement in each clinical score. No significant difference was seen in the clinical outcome scores and the meniscal healing status between the two groups at second-look arthroscopy. Moreover, no significant progression of cartilage damage was observed in both groups. Fourteen patients in the F-MMA group developed a complication of suture bar failures postoperatively; however, there were no complications in the TSS group.
The TSS and F-MMA techniques showed favourable clinical outcomes and would be established as clinically useful techniques for the MMPRT treatment.
胫骨内侧半月板后根撕裂（MMPRT）的经胫骨拉出修复术是一种常用的手术方法，已有多种技术被报道。我们假设使用两种简单缝线（TSS）的拉出修复术与使用带FasT-Fix的改良Mason-Allen缝线（F-MMA）的术后效果相似。我们旨在研究这些技术的临床结果，包括半月板愈合情况和骨关节炎变化。
回顾性研究68例行经胫骨拉出修复术患者的数据。患者分别分为使用F-MMA的41例组和使用TSS的27例组。术前及二次关节镜检查（手术平均时间为1年）时采用膝关节损伤和骨关节炎疗效评分评估临床结果。比较二次关节镜检查时两组的半月板愈合情况。根据国际软骨修复协会的分类对软骨损伤进行分级，并在初次手术和二次关节镜检查时进行比较。
两组各项临床评分均有显著改善。二次关节镜检查时两组的临床疗效评分和半月板愈合情况无显著差异。此外，两组均未观察到软骨损伤的显著进展。F-MMA组有14例患者术后出现缝线棒失败的并发症；然而，TSS组无并发症发生。
TSS和F-MMA技术显示出良好的临床效果，将成为治疗MMPRT的临床有用技术。
