Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
J Orthop Sci. 2022 Nov;27(6):1263-1270. doi: 10.1016/j.jos.2021.07.023. Epub 2021 Sep 14.
Different methods are available to assess the healing status of repaired root for medial meniscus posterior root tears (MMPRT) using second-look arthroscopy. However, few studies are comparing them or validating their usefulness. Therefore, it was hypothesized that the semi-quantitative arthroscopic score might correlate more with 1-year clinical outcomes in patients with MMPRT than the qualitative evaluation.
Data of 61 patients who underwent MMPRT pullout repair and second-look arthroscopy were retrospectively evaluated. The semi-quantitative arthroscopic scoring system was divided into three evaluation criteria: scores from 0 to 10 points include the width of the bridging tissue, stability of the repaired root, and synovial coverage. The qualitative evaluation was classified into 4 status; complete healing, lax healing, scar tissue healing, and failed healing according to the stability and mobility of the repaired root. Multivariate linear regression analyses were used to identify predictors of 1-year postoperative clinical outcomes, including Knee Injury and Osteoarthritis Outcome, Lysholm, or International Knee Documentation Committee scores. Spearman's correlation analysis was used to analyze the correlation between second-look arthroscopic score/qualitative evaluation and 1-year postoperative clinical outcomes. In addition, the optimal cutoff point of semi-quantitative arthroscopic score was determined by receiver operating characteristic (ROC) curve. The Mann-Whitney U test was used to compare clinical outcomes between patients with semi-quantitative arthroscopic scores ≥8 and scores <8.
All clinical scores significantly improved at 1 year postoperatively. A good correlation was observed between the semi-quantitative score and clinical scores, but none between qualitative evaluation and clinical scores. The optimal cutoff point of semi-quantitative second-look arthroscopic score was 8 points. Significantly, better clinical outcomes were observed in patients with semi-quantitative scores ≥8 points.
All 1-year postoperative clinical scores were significantly improved. The semi-quantitative arthroscopic scores correlate more with 1-year clinical outcomes in patients with MMPRT than the qualitative evaluation.
IV case series study.
对于内侧半月板后根部撕裂（MMPRT）的修复根愈合状态，有多种方法可通过再次关节镜检查进行评估。然而，很少有研究对这些方法进行比较或验证其有用性。因此，我们假设半定量关节镜评分与 MMPRT 患者 1 年临床结果的相关性可能优于定性评估。
回顾性分析了 61 例接受 MMPRT 抽出修复和再次关节镜检查的患者的数据。半定量关节镜评分系统分为 3 个评估标准：评分 0-10 分包括桥接组织的宽度、修复根的稳定性和滑膜覆盖。定性评估根据修复根的稳定性和活动性分为 4 种状态：完全愈合、松弛愈合、瘢痕组织愈合和失败愈合。采用多元线性回归分析确定 1 年术后临床结果的预测因素，包括膝关节损伤和骨关节炎结果评分、Lysholm 评分或国际膝关节文献委员会评分。采用 Spearman 相关分析分析再次关节镜评分/定性评估与 1 年术后临床结果的相关性。此外，通过受试者工作特征（ROC）曲线确定半定量关节镜评分的最佳截断点。采用 Mann-Whitney U 检验比较半定量关节镜评分≥8 分和<8 分患者的临床结果。
所有临床评分在术后 1 年均显著改善。半定量评分与临床评分之间存在良好相关性，但定性评估与临床评分之间无相关性。半定量二次关节镜检查评分的最佳截断点为 8 分。半定量评分≥8 分的患者临床结果明显更好。
所有 1 年术后临床评分均显著改善。与定性评估相比，半定量关节镜评分与 MMPRT 患者 1 年临床结果的相关性更强。
IV 级病例系列研究。
