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基于半月板后移进展比较两种简单缝线与改良梅森-艾伦缝合法治疗内侧半月板后根撕裂:一项回顾性队列研究

Comparison of two simple stitches and modified Mason-Allen suture for medial meniscus posterior root tear based on the progression of meniscal posterior extrusion: A retrospective cohort study.

作者信息

Kintaka Keisuke, Furumatsu Takayuki, Okazaki Yuki, Masuda Shin, Hiranaka Takaaki, Kodama Yuya, Kamatsuki Yusuke, Ozaki Toshifumi

机构信息

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 92057Okayama University, Okayama, Japan.

Department of Orthopaedic Surgery, 38335Chikamori Hospital, Kochi, Japan.

出版信息

J Orthop Surg (Hong Kong). 2021 Sep-Dec;29(3):23094990211049569. doi: 10.1177/23094990211049569.

DOI:10.1177/23094990211049569
PMID:34775855
Abstract

: Medial meniscus (MM) posterior root (PR) tear leads to severe MM posterior extrusion (PE), resulting in rapid knee cartilage degeneration. MMPR repairs are recommended to reduce MMPE, especially during knee flexion. However, the difference in MMPE between different repair techniques remains unknown. This study aimed to investigate preoperative and postoperative MMPE following several pullout repair techniques. We hypothesized that a technique using two simple stitches (TSS) would be more useful than FasT-Fix-dependent modified Mason-Allen suture (F-MMA) to prevent the progression of MMPE in knee extension. : This retrospective study included 35 patients who underwent MMPR repair. To compare MMPE, patients were divided into two groups according to the use of F-MMA while grasping the posterior capsule and TSS without grasping it. Open magnetic resonance imaging was performed at 10° and 90° knee flexion preoperatively, and at 3 and 12 months postoperatively, and the MMPE of both groups was evaluated. : A significant difference was observed between preoperative and 3-month postoperative MMPE at 90° knee flexion in both groups ( < .01). A significant difference was observed in 3- and 12-month postoperative MMPE at 10° knee flexion between both groups ( = .04/.02), whereas no significant difference in the preoperative MMPE at 10° knee flexion was observed between them ( = .45). : Both repairs were found to be useful to reduce MMPE in knee flexion. Further, F-MMA repair increased MMPE in knee extension, unlike TSS repair. These findings suggest that TSS might have more advantages for load distribution when standing or walking.

摘要

内侧半月板(MM)后根撕裂会导致严重的MM后移(PE),从而导致膝关节软骨迅速退变。建议进行MM后根修复以减少MM后移,尤其是在膝关节屈曲时。然而,不同修复技术之间MM后移的差异尚不清楚。本研究旨在调查几种拔出式修复技术术前和术后的MM后移情况。我们假设,一种使用两个简单缝线(TSS)的技术在防止膝关节伸展时MM后移进展方面比依赖FasT-Fix的改良梅森-艾伦缝线(F-MMA)更有效。

这项回顾性研究纳入了35例行MM后根修复的患者。为比较MM后移情况,根据是否使用F-MMA同时抓住后囊以及是否使用TSS且不抓住后囊,将患者分为两组。术前在膝关节屈曲10°和90°时,以及术后3个月和12个月时进行开放式磁共振成像,并评估两组的MM后移情况。

两组在膝关节屈曲90°时术前和术后3个月的MM后移情况均观察到显著差异(<0.01)。两组在膝关节屈曲10°时术后3个月和12个月的MM后移情况观察到显著差异(=0.04/0.02),而在膝关节屈曲10°时术前MM后移情况两组间未观察到显著差异(=0.45)。

两种修复方法均被发现对减少膝关节屈曲时的MM后移有效。此外,与TSS修复不同,F-MMA修复增加了膝关节伸展时的MM后移。这些发现表明,在站立或行走时,TSS在负荷分布方面可能具有更多优势。

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