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两种简单的缝合技术用于内侧半月板后根修复,可防止半月板外突进展,并比改良 Mason-Allen 缝线更好地降低半月板内信号强度。

Two simple stitches for medial meniscus posterior root repair prevents the progression of meniscal extrusion and reduces intrameniscal signal intensity better than modified Mason-Allen sutures.

机构信息

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2021 Aug;31(6):1005-1013. doi: 10.1007/s00590-020-02830-z. Epub 2020 Nov 21.

Abstract

PURPOSE

Medial meniscus posterior root tears (MMPRTs) can cause severe medial extrusion of the medial meniscus (MMME) and the progression of knee degenerative changes, inducing a high signal intensity of the meniscus on magnetic resonance imaging (MRI). Although MMME and intrameniscal signal intensity (IMSI) reportedly decreased within 3 months after MMPRT repair, no previous studies have reported these changes after a 1-year follow-up. This study aimed to investigate the 1-year postoperative changes in MMME and IMSI on MRI after using different suture techniques.

METHODS

Overall, 33 patients with MMPRT were evaluated, 22 underwent FasT-Fix-dependent modified Mason-Allen suture (F-MMA) repair, and 11 underwent two simple stitches (TSS) repair. MRI examinations were performed preoperatively and 1 year postoperatively. MMME and IMSI were determined using MRI.

RESULTS

A significant decrease in postoperative MMME was observed in the TSS group (4.1 ± 1.0) relative to that in the F-MMA group (5.1 ± 1.4, P = 0.03). A significant decrease in postoperative IMSI (0.75 ± 0.14) was observed relative to preoperative IMSI in the TSS group (P < 0.01), whereas postoperative IMSI (0.94 ± 0.25) was similar to preoperative IMSI in the F-MMA group (P = 0.06). Furthermore, a significant decrease in postoperative IMSI was observed in the TSS group relative to that in the F-MMA group (P < 0.01).

CONCLUSIONS

The most important finding of this study is that TSS repair yielded a greater decrease in MMME and IMSI than F-MMA repair in patients with MMPRT. These results suggest that TSS repair is more useful for restoring loading stress to the posterior horn of the medial meniscus.

摘要

目的

内侧半月板后根部撕裂(MMPRT)可导致内侧半月板(MMME)严重内侧外突和膝关节退行性改变,在磁共振成像(MRI)上半月板出现高信号强度。尽管据报道 MMPRT 修复后 3 个月内 MMME 和半月板内信号强度(IMSI)会降低,但以前的研究并未报告 1 年后的这些变化。本研究旨在探讨使用不同缝合技术后 MMPRT 修复后 1 年 MMME 和 IMSI 的术后变化。

方法

共评估了 33 例 MMPRT 患者,22 例行 FasT-Fix 依赖性改良 Mason-Allen 缝合(F-MMA)修复,11 例行双简单缝合(TSS)修复。术前和术后 1 年进行 MRI 检查。使用 MRI 确定 MMME 和 IMSI。

结果

TSS 组术后 MMME (4.1±1.0)明显低于 F-MMA 组(5.1±1.4,P=0.03)。TSS 组术后 IMSI(0.75±0.14)明显低于术前 IMSI(P<0.01),而 F-MMA 组术后 IMSI(0.94±0.25)与术前 IMSI 相似(P=0.06)。此外,TSS 组术后 IMSI 明显低于 F-MMA 组(P<0.01)。

结论

本研究的重要发现是,TSS 修复在 MMPRT 患者中较 F-MMA 修复更能降低 MMME 和 IMSI。这些结果表明,TSS 修复更有助于恢复内侧半月板后角的负荷应力。

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