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术后半月板挤出与内侧半月板后根撕裂拉出固定技术临床结果之间的关联。

Association between postoperative meniscal extrusion and clinical outcomes of the pullout fixation technique for medial meniscus posterior root tear.

作者信息

Yanagisawa Shinya, Kimura Masashi, Hagiwara Keiichi, Ogoshi Atsuko

机构信息

Zensyukai Hospital Gunma Sports Medicine Research Center, Gunma, Japan.

出版信息

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2020 Jun 12;21:27-31. doi: 10.1016/j.asmart.2020.05.001. eCollection 2020 Jul.

Abstract

OBJECTIVE

To evaluate the correlation between meniscal extrusion in the coronal plane with clinical and radiological outcomes at a minimum of 1 year after transtibial pullout fixation for medial meniscus posterior root tear (MMPRT).

METHODS

Data from 30 patients (five males, 25 females) with MMPRT who underwent arthroscopic root fixation by the transtibial pullout technique between 2011 and January 2015 were retrospectively analyzed. The mean patient age was 60.7 ± 8.3years. The median time between injury and surgery was 3.8 months (range, 0.5-15 months). Medial meniscus radial displacement was assessed on magnetic resonance imaging performed preoperatively and at 1 year after fixation. The patients were divided into two groups based on the presence on magnetic resonance imaging of decreased meniscal extrusion (group A) or increased meniscal extrusion (group B) at 1 year postoperatively compared with preoperatively. The two groups were compared regarding factors including age at surgery, sex, body mass index, time between injury and surgery, and the Lysholm score and Kellgren-Lawrence (K-L) grade preoperatively and at 1 year postoperatively.

RESULTS

There were seven knees in group A, and 23 in group B. Both groups had a significantly improved Lysholm score postoperatively compared with preoperatively (p < 0.001). Although the postoperative K-L grade was significantly worse than the preoperative K-L grade in group B (p < 0.001), the postoperative K-L grade did not worsen postoperatively in group A.

CONCLUSION

The K-L grade did not worsen postoperatively in the group with decreased meniscal extrusion at 1 year after transtibial pullout fixation for MMPRT compared with preoperatively.

摘要

目的

评估内侧半月板后根撕裂(MMPRT)经胫骨拉出固定术后至少1年时,冠状面半月板挤出与临床和影像学结果之间的相关性。

方法

回顾性分析2011年至2015年1月期间30例接受经胫骨拉出技术关节镜下根部固定的MMPRT患者(5例男性,25例女性)的数据。患者平均年龄为60.7±8.3岁。受伤至手术的中位时间为3.8个月(范围0.5 - 15个月)。在术前及固定术后1年进行的磁共振成像上评估内侧半月板的径向移位。根据术后1年与术前相比磁共振成像上半月板挤出减少(A组)或半月板挤出增加(B组)将患者分为两组。比较两组在手术年龄、性别、体重指数、受伤至手术时间以及术前和术后1年的Lysholm评分和Kellgren-Lawrence(K-L)分级等因素。

结果

A组有7个膝关节,B组有23个膝关节。两组术后Lysholm评分均较术前显著改善(p < 0.001)。虽然B组术后K-L分级显著差于术前(p < 0.001),但A组术后K-L分级未恶化。

结论

与术前相比,MMPRT经胫骨拉出固定术后1年半月板挤出减少组的K-L分级未恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ef1/7298548/6e6ce5cc1d43/gr1.jpg

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