Anne Arundel Medical Center Orthopedics, 2000 Medical Parkway, Suite 101, Annapolis, MD 21401, United States.
Anne Arundel Medical Center Orthopedics, 2000 Medical Parkway, Suite 101, Annapolis, MD 21401, United States.
Knee. 2021 Jan;28:9-16. doi: 10.1016/j.knee.2020.10.012. Epub 2020 Dec 2.
This study examines the relationship between meniscus tear presentations and failure rates following all-inside repair in isolation and in conjunction with an anterior cruciate ligament (ACL) reconstruction.
Eighty seven consecutive patients undergoing all-inside meniscal repair at a single institution from July 2016 to June 2018 were retrospectively reviewed. Details of patient presentation, tear type and location, the presence or absence of simultaneous ACL reconstruction, and surgical repair details were recorded to evaluate the relationship between patient characteristics and the primary endpoint of repair failure.
Patients were followed for an average of 2.7 ± 0.8 years. Three patients (3.4%) experienced 30-day complications including 1 deep vein thrombosis and 2 joint aspirations. Within the study time frame, 15 repairs (17.2%) failed, with 10 (11.5%) failing within one year of the initial procedure; the average time to failure was 12.3 ± 9.0 months. Patients undergoing concurrent ACL reconstruction were less likely to experience repair failure (9.7% vs. 36.0%, p = .009), while bucket-handle repairs were more likely to fail during the study period (45.0% vs. 9.0%, p = .001). These trends remained after controlling for tear location, body mass index, and number of sutures (ACL reconstruction Odds Ratio [OR]: 0.229, p = .029; Bucket-handle OR: 9.400, p = .003).
Our findings suggest concurrent ACL reconstruction at the time of meniscal repair is associated with increased repair survival. The all-inside technique may be successfully used across a variety of tear types and locations, although further study of its efficacy in repairing bucket-handle tears is warranted.
本研究旨在单独评估和结合前交叉韧带（ACL）重建评估半月板撕裂表现与全内修复失败率之间的关系。
回顾性分析 2016 年 7 月至 2018 年 6 月在一家机构行全内半月板修复的 87 例连续患者。记录患者的表现、撕裂类型和位置、是否同时进行 ACL 重建以及手术修复的详细信息，以评估患者特征与修复失败的主要终点之间的关系。
患者平均随访 2.7±0.8 年。3 例（3.4%）发生 30 天内并发症，包括 1 例深静脉血栓形成和 2 例关节抽吸。在研究期间，15 例修复失败，其中 10 例（11.5%）在初始手术后 1 年内失败；平均失败时间为 12.3±9.0 个月。同时进行 ACL 重建的患者修复失败的可能性较小（9.7% vs. 36.0%，p=0.009），而在研究期间，桶柄状撕裂更有可能失败（45.0% vs. 9.0%，p=0.001）。在控制撕裂位置、体重指数和缝线数量后，这些趋势仍然存在（ACL 重建的比值比[OR]：0.229，p=0.029；桶柄状撕裂 OR：9.400，p=0.003）。
我们的研究结果表明，半月板修复时同时进行 ACL 重建与修复存活率增加相关。全内技术可成功应用于多种撕裂类型和位置，尽管需要进一步研究其修复桶柄状撕裂的效果。
