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关节镜下中央化作为内侧半月板后根撕裂引起的内侧半月板挤出的增强治疗的短期结果和手术技术。

Short-term results and surgical technique of arthroscopic centralization as an augmentation for medial meniscus extrusion caused by medial meniscus posterior root tear.

机构信息

Department of Orthopaedics Surgery (Ohashi), School of Medicine, Toho University, 2-22-36 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2021 Aug;31(6):1235-1241. doi: 10.1007/s00590-021-02874-9. Epub 2021 Jan 21.

Abstract

INTRODUCTION

The purpose of this study was to perform medial meniscus (MM) centralization for medial meniscus extrusion (MME) associated with medial meniscus posterior root tear (MMPRT) and to examine the short-term results. The hypothesis is that arthroscopic centralization as an augmentation of MMPRT repair improves clinical outcomes and the extrusion distance of MM in short-term results.

MATERIALS AND METHODS

Twenty-six patients (mean age 62.1 ± 6.0 years) who underwent arthroscopic centralization as an augmentation of MMPRT repair were included. Clinical evaluation was performed before and 2 years after surgery using Lysholm score and knee injury and osteoarthritis outcome score (KOOS). Image evaluation used MRI and plain X-ray images. The extrusion distance and MME ratio were compared on MRI images before and 2 years after surgery. The degree of osteoarthritis (OA) was evaluated using Kellgren-Lawrence classification. The degree of OA and hip-knee-ankle (HKA) angle were compared by plane X-ray images before and 2 years after surgery.

RESULTS

In clinical results, both Lysholm score and KOOS improved significantly after surgery. In image evaluation, the extrusion distance decreased significantly from 4.8 ± 0.7 mm before surgery to 2.7 ± 0.3 mm 2 years after surgery (p < 0.05). The MME ratio was significantly improved from 40.2 ± 7.0% before surgery to 22.6 ± 3.6% after surgery (p < 0.05). There was no significant difference in HKA angle at 2 years after surgery (p = 0.13).

CONCLUSIONS

The arthroscopic centralization for medial meniscal extrusion associated with MMPRT significantly improved clinical outcomes and the extrusion distance of MM. It is also one of the surgical techniques that can suppress medial meniscus extrusion.

LEVEL OF EVIDENCE

IV, therapeutic case series.

摘要

介绍

本研究的目的是对内侧半月板后根撕裂(MMPRT)伴发的内侧半月板挤压(MME)进行内侧半月板(MM)中央化治疗,并观察短期结果。假设是关节镜下中央化作为 MMPRT 修复的增强可以改善临床结果和 MM 的挤压距离。

材料和方法

共纳入 26 例(平均年龄 62.1±6.0 岁)患者,这些患者均接受关节镜下中央化作为 MMPRT 修复的增强治疗。术前和术后 2 年分别采用 Lysholm 评分和膝关节损伤和骨关节炎评分(KOOS)进行临床评估。影像学评估采用 MRI 和 X 线平片。比较术前和术后 2 年 MRI 图像上的挤压距离和 MME 比值。采用 Kellgren-Lawrence 分级评估骨关节炎(OA)程度。比较术前和术后 2 年 X 线平片上的 OA 程度和髋膝踝(HKA)角。

结果

临床结果显示,术后 Lysholm 评分和 KOOS 均显著改善。影像学评估显示,挤压距离从术前的 4.8±0.7mm 显著降低至术后 2 年的 2.7±0.3mm(p<0.05)。MME 比值从术前的 40.2±7.0%显著改善至术后 2 年的 22.6±3.6%(p<0.05)。术后 2 年 HKA 角无显著差异(p=0.13)。

结论

关节镜下内侧半月板挤压伴 MMPRT 的中央化治疗显著改善了临床结果和 MM 的挤压距离。它也是一种可以抑制内侧半月板挤压的手术技术。

证据水平

IV,治疗性病例系列。

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