关节镜下全内双垂直交叉缝合技术治疗外侧半月板完全放射状撕裂：2 年以上随访证实该方法有效且安全。
Repairing Complete Radial Tears of the Lateral Meniscus: Arthroscopic All-Inside Double Vertical Cross-Suture Technique Is Effective and Safe With 2-Year Minimum Follow-Up.
机构信息
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan.
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopedic Surgery, Taoyuan General Hospital, Ministry of Health & Welfare, Taoyuan, Taiwan; Orthopedics Department of Kuang Tien General Hospital, Taichung, Taiwan.
出版信息
Arthroscopy. 2022 Jun;38(6):1919-1929. doi: 10.1016/j.arthro.2021.11.025. Epub 2021 Nov 25.
PURPOSE
To assess the failure rate and clinical outcomes of the all-inside, double-vertical, cross-suture technique in repairing complete radial tears of the lateral meniscus.
METHOD
We retrospectively reviewed records of patients with this injury on whom the present technique was employed at our institution between 2011 and 2018, with at least 24 months of follow-up. Six months postoperatively, the meniscus healing and extrusion status were evaluated through magnetic resonance imaging. Preoperative and postoperative knee function, measured through IKDC, Lysholm knee, and Tegner activity scale scores, were compared.
RESULTS
In total, 27 patients underwent the procedure. The preoperative mean (standard deviation) IKDC score, Lysholm knee score, and Tegner activity scale scores were 53.4 ± 5.3, 63.2 ± 9.3, and 4 ± .7, respectively. At the last follow-up (≥24 months postoperatively), these scores increased to 92.1 ± 2.6, 90.8 ± 4.2, and 6.1 ± 1.3, respectively (all P < .05). Complete healing of the meniscus was observed in 23 patients, and 4 patients had meniscus retear or nonhealing. The overall retear or nonhealing rate was 14.8%. Healing rates between those with isolated radial tears (87.5%) and those with combined anterior cruciate ligament rupture (84.2%; P = .826) were comparable. No difference was observed in the progression of coronal and sagittal meniscus extrusion (P = .133 and .797, respectively).
CONCLUSION
In patients with complete radial tears of the lateral meniscus, the arthroscopic all-inside double vertical cross-suture repair technique resulted in an 85.2% healing rate, improvements in functional outcomes and activity levels, and no identifiable progression of meniscus extrusion. The all-inside double vertical cross-suture technique is effective and safe for the repair of radial tears of the meniscus.
LEVEL OF EVIDENCE
Level IV, retrospective case series.
目的
评估全内、双垂直、交叉缝合技术修复外侧半月板完全放射状撕裂的失败率和临床结果。
方法
我们回顾性分析了 2011 年至 2018 年在我院接受该技术治疗的外侧半月板完全放射状撕裂患者的病历资料，所有患者均获得至少 24 个月的随访。术后 6 个月，通过磁共振成像评估半月板愈合和挤出情况。比较术前和术后的膝关节功能，通过 IKDC、Lysholm 膝关节评分和 Tegner 活动量表评分进行评估。
结果
共 27 例患者接受了该手术。术前平均（标准差）IKDC 评分、Lysholm 膝关节评分和 Tegner 活动量表评分为 53.4±5.3、63.2±9.3 和 4±0.7，分别。末次随访（术后≥24 个月）时，这些评分分别增加至 92.1±2.6、90.8±4.2 和 6.1±1.3（均 P<0.05）。23 例患者半月板完全愈合，4 例患者半月板再撕裂或未愈合。总的再撕裂或未愈合率为 14.8%。单纯放射状撕裂患者（87.5%）与合并前交叉韧带撕裂患者（84.2%；P=0.826）的愈合率相当。冠状面和矢状面半月板挤出的进展无差异（P=0.133 和 0.797，分别）。
结论
在外侧半月板完全放射状撕裂患者中，关节镜下全内双垂直交叉缝合修复技术的愈合率为 85.2%，功能和活动水平改善，半月板挤出无明显进展。全内双垂直交叉缝合技术是修复半月板放射状撕裂的有效且安全的方法。
证据等级
IV 级，回顾性病例系列。
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