前交叉韧带重建与半月板修复的关系：生活质量、运动恢复和半月板失败率-2-12 年随访。
The relationship between ACL reconstruction and meniscal repair: quality of life, sports return, and meniscal failure rate-2- to 12-year follow-up.
机构信息
Orthopedic & Trauma Surgery Dept, Hospital Clínic, C/Villarroel 170, 08036, Barcelona, Spain.
CLINICA SAGRADA FAMILIA BARCELONA, c/torras i pujalt 1, 08022, Barcelona, Spain.
出版信息
J Orthop Surg Res. 2020 Aug 27;15(1):361. doi: 10.1186/s13018-020-01878-1.
BACKGROUND
Few studies have approached in a long-term follow-up of meniscal repair at an amateur level, specially studying variables as a quality of life and failure rate. The purpose of this review is to study medium to long-term clinical results in patients at amateur sports patients, that have required meniscal sutures at our center, with or without ACL reconstruction. We evaluate the objective function of the knee, as well as patients' return to sports activities, quality of life, and the rate of failed repair and study of the possible reasons.
METHODS
This was an observational retrospective study. Ninety-two patients who regularly perform amateur sports activities (Tegner 4 to 7) were assessed, with a minimum follow-up period of 2 years, divided into 2 groups: group 1, isolated meniscal suture (43 cases) and group 2, associated to ACL reconstruction (49 cases). Each patient made this test in 2019: Lysholm and Tegner (validated for Spanish) before a knee injury and after surgery, motivation to return to sports activity (Likert scale with 3 items: low, regular, or high), and quality of life through SD-12 test.
RESULTS
High return to amateur sports rate (92%) was even higher in the isolated meniscal repair group in comparison to the group with associated ACL. We have not found statistically significant differences between sports return and age, gender, injured meniscus, chondral injuries, preoperative Tegner score, or motivation. No significant differences in physical or mental health fields between both groups. Meniscal repair failed in 12 patients (13%). Higher rate of failure in isolated bucket-handle tear injuries (p < 0.0062). No statistically significant association was found between the other variables studied.
CONCLUSIONS
Good results with 92% of sports return, low rate of complications, and low retear rate, even lower when is associated with ACL reconstruction and in external meniscus repair, and high values at SF-12 between 2 groups.
背景
很少有研究在业余水平的半月板修复的长期随访中进行，特别是研究生活质量和失败率等变量。本研究的目的是研究在我们中心接受半月板缝合术的业余运动员患者的中至长期临床结果，无论是否合并 ACL 重建。我们评估膝关节的客观功能，以及患者重返运动活动的情况、生活质量、修复失败率，并研究可能的原因。
方法
这是一项观察性回顾性研究。我们评估了 92 名经常进行业余运动（Tegner 4 至 7 级）的患者，随访时间至少 2 年，分为 2 组：组 1，单纯半月板缝合（43 例）和组 2，合并 ACL 重建（49 例）。每位患者在 2019 年进行了以下测试：在膝关节受伤前和手术后进行 Lysholm 和 Tegner（经西班牙验证）评分、重返运动活动的动力（3 项的 Likert 量表：低、常规或高）和通过 SD-12 测试评估生活质量。
结果
高重返业余运动率（92%）在单纯半月板修复组更高，与合并 ACL 的组相比。我们没有发现运动回归与年龄、性别、受伤的半月板、软骨损伤、术前 Tegner 评分或动力之间存在统计学差异。两组之间在身体或心理健康领域没有显著差异。12 名患者（13%）的半月板修复失败。单纯桶柄状撕裂损伤的失败率更高（p < 0.0062）。未发现研究的其他变量之间存在统计学关联。
结论
92%的患者重返运动，并发症发生率低，再撕裂率低，尤其是在合并 ACL 重建和外侧半月板修复时，SF-12 两组之间的分值较高。
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