Okazaki Yuki, Furumatsu Takayuki, Hiranaka Takaaki, Kintaka Keisuke, Higashihara Naohiro, Tamura Masanori, Ozaki Toshifumi
Department of Orthopaedic Surgery, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0841, Japan; Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Knee. 2022 Mar;35:71-80. doi: 10.1016/j.knee.2022.02.004. Epub 2022 Feb 24.
The medial meniscus (MM) translates posteriorly and extrudes severely from the medial tibial plateau (MTP) during knee flexion in the MM posterior root tear (PRT) knee. Transtibial pullout repair of the MMPRT has been performed to regulate MM extrusion. This study aimed to evaluate pullout suture translation during knee flexion before and after posterior anchoring during pullout repair. We hypothesized that suture translation after posterior anchoring would be significantly decreased relative to that before posterior anchoring.
Thirty-five patients who underwent MM posterior root repair were prospectively investigated. Pullout repair was performed using two cinch sutures (outer and inner sutures) and posterior anchoring through the MM posterior horn and an additional bone tunnel on the MTP. The translation of the outer suture from 0° to 90° of knee flexion was measured and compared before and after posterior anchoring intraoperatively. The MM morphologic features were measured using preoperative magnetic resonance imaging, and the correlation between these values and outer suture translation was evaluated.
The average outer suture translation after posterior anchoring (1.6 ± 1.5 mm) was significantly decreased relative to that before posterior anchoring (2.5 ± 1.7 mm, P < 0.01). No significant correlations were observed between the MM morphological features and outer suture translation.
The posterior anchoring method with an MM posterior root repair is useful in decreasing posterior translation of the pullout suture during knee flexion, which might have an advantage in preventing suture pullout from the repaired MM, leading to good clinical outcomes.
在半月板后根撕裂(PRT)的膝关节中,屈膝时内侧半月板(MM)向后移位并从内侧胫骨平台(MTP)严重挤出。已进行半月板后根撕裂的经胫骨拉出修复术以调节半月板挤出。本研究旨在评估拉出修复过程中后锚固前后屈膝时拉出缝线的移位情况。我们假设后锚固后的缝线移位相对于后锚固前会显著减少。
对35例行半月板后根修复的患者进行前瞻性研究。采用两根收紧缝线(外缝线和内缝线)进行拉出修复,并通过半月板后角和MTP上的额外骨隧道进行后锚固。术中测量并比较后锚固前后屈膝0°至90°时外缝线的移位情况。术前使用磁共振成像测量半月板形态特征,并评估这些值与外缝线移位之间的相关性。
后锚固后外缝线的平均移位(1.6±1.5mm)相对于后锚固前(2.5±1.7mm,P<0.01)显著减少。半月板形态特征与外缝线移位之间未观察到显著相关性。
半月板后根修复的后锚固方法有助于减少屈膝时拉出缝线的后向移位,这可能在防止缝线从修复的半月板中拉出方面具有优势,从而带来良好的临床效果。