Kim Sang-Gyun, Kim Soo-Hyun, Baek Jung-Heum, Kim Jae-Gyoon, Jang Ki-Mo, Lim Hong-Chul, Bae Ji-Hoon
Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan‑si, Gyeongki‑do, 15355, Republic of Korea.
Department of Orthopaedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
Knee Surg Relat Res. 2019 Nov 1;31(1):11. doi: 10.1186/s43019-019-0009-z.
The Multicenter Orthopaedic Outcomes Network (MOON) group recently reported that medial meniscus (MM) repairs are associated with more frequent re-operations when compared to lateral meniscus (LM) repairs. The purpose of this study was to compare the meniscal healing and the incidence of subsequent re-operation of medial and lateral meniscal tears that occurred concurrently with anterior cruciate ligament (ACL) injuries.
We retrospectively reviewed patients who underwent second-look arthroscopy after primary ACL reconstruction (ACLR) between June 2005 to December 2016. The healing of meniscal tears following repair or left in situ, and re-tear following partial meniscectomy, were evaluated via second-look arthroscopy and compared between medial and lateral meniscus. Moreover, the incidence of subsequent meniscal re-operation after the index ACLR were investigated and compared between medial and lateral meniscus. Subsequent meniscal re-operation was performed in cases of the following three symptomatic meniscus tears: re-tears at the meniscectomy site; new tears; and failed healing of repaired or left in situ meniscus.
There were 148 meniscal tears in 121 patients at index ACLR. There were 62 MM tears, 38 LM tears, and 24 bilateral meniscus tears. At second-look arthroscopy, the "successful healing" rate for tears following repair was higher in LM tears (91.2%) compared to MM tears (80.0%), although it was not statistically significant (p > 0.05). No significant differences were observed in the healing of left in situ tears or re-tear of meniscectomy site between medial and lateral meniscus. Patients with MM tears combined with ACL injuries had a higher incidence of subsequent meniscal re-operation compared to patients with LM tears (25.6% vs 16.1%, p = 0.025).
There was a trend for the successful healing rate to be higher in LM repairs than MM repairs. Subsequent meniscal re-operations after ACLR were more frequent in patients with medial meniscal tears concurrently with ACL injuries in comparison to patients with lateral meniscal tears.
Level IV, retrospective case series.
多中心骨科结局网络（MOON）小组最近报告称，与外侧半月板（LM）修复相比，内侧半月板（MM）修复与更频繁的再次手术相关。本研究的目的是比较与前交叉韧带（ACL）损伤同时发生的内侧和外侧半月板撕裂的半月板愈合情况以及随后再次手术的发生率。
我们回顾性分析了2005年6月至2016年12月期间接受初次ACL重建（ACLR）后二次关节镜检查的患者。通过二次关节镜检查评估半月板撕裂修复或原位保留后的愈合情况，以及部分半月板切除术后的再次撕裂情况，并在内侧和外侧半月板之间进行比较。此外，还调查并比较了初次ACLR后内侧和外侧半月板随后进行半月板再次手术的发生率。在以下三种有症状的半月板撕裂情况下进行了随后的半月板再次手术：半月板切除部位的再次撕裂；新的撕裂；以及修复或原位保留的半月板愈合失败。
初次ACLR时，121例患者中有148处半月板撕裂。其中内侧半月板撕裂62处，外侧半月板撕裂38处，双侧半月板撕裂24处。在二次关节镜检查时，外侧半月板撕裂修复后的“成功愈合”率（91.2%）高于内侧半月板撕裂（80.0%），尽管差异无统计学意义（p>0.05）。在内侧和外侧半月板之间，原位保留撕裂的愈合情况或半月板切除部位的再次撕裂情况未观察到显著差异。与外侧半月板撕裂患者相比，内侧半月板撕裂合并ACL损伤的患者随后进行半月板再次手术的发生率更高（25.6%对16.1%，p=0.025）。
外侧半月板修复的成功愈合率有高于内侧半月板修复的趋势。与外侧半月板撕裂患者相比，内侧半月板撕裂合并ACL损伤的患者在ACLR后进行半月板再次手术的频率更高。
IV级，回顾性病例系列。
