Department of Orthopedics and Traumatology, Health Application and Research Center, University of Health Sciences, Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Department of Orthopedics and Traumatology, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey.
J Knee Surg. 2022 Sep;35(11):1242-1248. doi: 10.1055/s-0040-1722624. Epub 2021 Jan 28.
The aim of this study was to evaluate the success of the all-inside repair technique for medial bucket-handle meniscus tear (BHMT) and the factors affecting healing. A total of 36 patients with BHMT who were operated between 2012 and 2018 and completed final follow-up examinations were included in the study. Functional evaluation was made with the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score. Healing was evaluated on magnetic resonance imaging (MRI) slices. The patients were evaluated with respect to the effect on healing of factors such as demographic data, body mass index (BMI), smoking status, anterior cruciate ligament tear reconstruction (ACLTR) applied at the same time as BHMT repair, and the tear being chronic or acute. The mean age of the patients was 28.6 ± 8.6 years (range,18-46 years), the mean follow-up period was 25.8 ± 13.9 months (range, 13-59 months), and BMI was mean 25.6 ± 3.5 kg/m (range, 20.1-30.5 kg/m). The meniscus tears were acute in 16 (44.4%) patients and chronic in 20 (55.6%). ACLTR was applied together with BHMT repair in 25 patients. The hybrid technique, as the outside-in technique in addition to the all-inside technique, was applied to 12 (33.3%) patients, where there was seen to be extension to the anterior horn. The failure rate was determined as 27.8% according to the postoperative MRI evaluation and the Barrett criteria. No positive or negative statistically significant effect on healing was determined of chronic BHMT or of simultaneous application of ACLTR ( = 1.00 and 0.457, respectively). Cigarette smoking and high BMI were determined to have a statistically significant negative effect on healing ( = 0.026 and 0.007, respectively). In conclusion, it can be seen that the success of the all-inside technique for BHMT remains controversial. Due to the features of the application, it can be used in meniscus tears of the posterior horn only. In the current study, with the success rate of 72.2% of the all-inside technique in meniscus body tears, it was seen that a high success rate could not be achieved.
本研究旨在评估全内修复技术治疗内侧桶柄状半月板撕裂（BHMT）的成功率和影响愈合的因素。纳入了 2012 年至 2018 年间接受手术且完成最终随访检查的 36 例 BHMT 患者。采用国际膝关节文献委员会（IKDC）评分、Lysholm 评分和 Tegner 评分进行功能评估。通过磁共振成像（MRI）切片评估愈合情况。评估了患者的愈合情况，包括人口统计学数据、体重指数（BMI）、吸烟状况、与 BHMT 修复同时进行的前交叉韧带撕裂重建（ACLTR）以及撕裂是急性还是慢性等因素对愈合的影响。患者的平均年龄为 28.6±8.6 岁（18-46 岁），平均随访时间为 25.8±13.9 个月（13-59 个月），BMI 均值为 25.6±3.5kg/m（20.1-30.5kg/m）。16 例（44.4%）半月板撕裂为急性，20 例（55.6%）为慢性。25 例患者同时行 ACLTR 修复。在 12 例（33.3%）患者中，除了全内技术外，还采用了混合技术（即外加的外-内技术），发现前角有延伸。根据术后 MRI 评估和 Barrett 标准，失败率为 27.8%。慢性 BHMT 或同时进行 ACLTR 的应用对愈合无明显的正、负影响（=1.00 和 0.457）。吸烟和高 BMI 对愈合有显著的负影响（=0.026 和 0.007）。总之，全内技术治疗 BHMT 的成功率仍然存在争议。由于该技术的应用特点，只能用于半月板后角撕裂。在本研究中，全内技术治疗半月板体部撕裂的成功率为 72.2%，不能取得较高的成功率。
