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经皮胫骨结节内固定修复术结合双缝线固定技术治疗半月板后根部撕裂,可预防内侧半月板外移进展,获得满意疗效。

Transtibial pullout repair techniques using two simple stitches for medial meniscus posterior root tear can prevent the progression of medial meniscus extrusion and obtain successful outcomes.

机构信息

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2022 Jul;32(5):795-802. doi: 10.1007/s00590-021-03035-8. Epub 2021 Jun 17.

DOI:10.1007/s00590-021-03035-8
PMID:34137941
Abstract

PURPOSE

Transtibial pullout repairs using two simple stitches (TSS) and a combination of TSS with posteromedial pullout repair (TSS + PMP) using an all-inside meniscal repair device have been reported previously for the treatment of medial meniscus (MM) posterior root tears. This study aimed to investigate the postoperative clinical outcomes of these techniques including MM extrusion (MME).

METHODS

Fifty-two patients who underwent transtibial pullout repair were investigated and divided into TSS (n = 27) and TSS + PMP (n = 25) groups. The clinical outcomes were assessed using the Lysholm knee score and Knee Injury and Osteoarthritis Outcome Score 1 year postoperatively and compared between two groups. MME was measured using magnetic resonance imaging at 1 year postoperatively and compared between two groups.

RESULTS

A significant improvement in each clinical score was observed in both groups, and no significant difference was seen in clinical outcomes. Moreover, no significant difference in postoperative MME was observed in both groups (TSS and TSS + PMP: 3.5 mm and 3.8 mm, respectively). Though no significant progression of MME was observed in TSS group, a significant progression of it was observed in TSS + PMP group postoperatively.

CONCLUSIONS

This study demonstrated that both techniques improved clinical outcomes in the short-term postoperative period. However, MME was progressed significantly in TSS + PMP group 1 year postoperatively, which indicated that PMP might not be a useful additional procedure for reducing the postoperative MME.

摘要

目的

经胫骨隧道抽出修复术(TSS)联合使用全内半月板修复装置的后内侧抽出修复术(TSS+PMP)治疗内侧半月板(MM)后根撕裂已有报道。本研究旨在探讨这些技术的术后临床疗效,包括 MM 外突(MME)。

方法

对 52 例行经胫骨隧道抽出修复术的患者进行了研究,分为 TSS(n=27)和 TSS+PMP(n=25)组。术后 1 年采用 Lysholm 膝关节评分和膝关节损伤和骨关节炎结果评分(KOOS)评估临床疗效,并对两组进行比较。术后 1 年采用 MRI 测量 MME,并对两组进行比较。

结果

两组患者的临床评分均有显著改善,且临床疗效无显著差异。此外,两组术后 MME 无显著差异(TSS 和 TSS+PMP:分别为 3.5mm 和 3.8mm)。TSS 组术后 MME 无显著进展,但 TSS+PMP 组术后 MME 显著进展。

结论

本研究表明,两种技术均可在短期术后改善临床疗效。然而,TSS+PMP 组术后 1 年 MME 显著进展,表明 PMP 对减少术后 MME 可能没有帮助。

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本文引用的文献

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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.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。
Eur J Orthop Surg Traumatol. 2021 Aug;31(6):1005-1013. doi: 10.1007/s00590-020-02830-z. Epub 2020 Nov 21.
2
Medial meniscus posterior root repair prevents the progression of subchondral insufficiency fracture of the knee.内侧半月板后根修复可防止膝关节软骨下骨不全骨折的进展。
J Orthop Sci. 2021 Nov;26(6):1051-1055. doi: 10.1016/j.jos.2020.10.008. Epub 2020 Nov 6.
3
内侧半月板后根撕裂修复与其他内侧半月板修复术后患者报告结局的比较:单臂队列的探索性荟萃分析。
J Am Acad Orthop Surg Glob Res Rev. 2024 Sep 25;8(9). doi: 10.5435/JAAOSGlobal-D-23-00293. eCollection 2024 Sep 1.
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Accuracy of the newly developed Zimmer Biomet Root Aiming guide in tibial tunnel creation compared with that of conventional guides.与传统导向器相比,新开发的捷迈邦美(Zimmer Biomet)根部瞄准导向器在胫骨隧道创建中的准确性。
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