Holmes S Wendell, Huff Logan W, Montoya Katherine J, Durkin Martin W, Baier Adam J
Prisma Health USC Orthopedics, Columbia, South Carolina, U.S.A.
University of South Carolina School of Medicine, Columbia, South Carolina, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Jun 3;4(4):e1339-e1346. doi: 10.1016/j.asmr.2022.04.018. eCollection 2022 Aug.
To describe patient-reported clinical outcomes and complications of anatomic medial meniscal root reconstruction with gracilis autograft.
Data on patients who underwent arthroscopic medial meniscal root reconstruction with gracilis autograft were prospectively collected between 2017 and 2021 and retrospectively reviewed. The inclusion criteria were symptomatic posterior medial meniscal LaPrade type 2 root tears with no more than Outerbridge grade 2 chondrosis of any knee compartment with a minimum follow-up period of 1 year. Patients with ligamentous instability and those with Workers' Compensation status were excluded. Patient-reported outcomes (12-item Short Form Survey [SF-12], visual analog scale [VAS], Western Ontario and McMaster Universities Arthritis Index [WOMAC], and Lysholm scores) were collected prospectively and analyzed retrospectively and were scored and recorded both preoperatively and at postoperative intervals. Data were analyzed using cubic spline regression models. The study was approved by the University of South Carolina Institutional Review Board.
A consecutive series of 27 patients treated by a single surgeon were evaluated. Twenty-one patients were included for data analysis (4 were excluded per criteria and 2 were lost to follow-up) with an average age of 48.1 years (range, 16-63 years). There were 18 female and 3 male patients. The average follow-up time was 25.2 months (range, 12-42 months). At the postoperative time points captured by the data examined, improvements in Lysholm, WOMAC, VAS, and SF-12 physical component summary scores were found to be statistically significant ( < .001, 95% confidence interval). Improvements in SF-12 mental component summary scores, however, did not reach the level of statistical significance ( = .262). Body mass index greater than 35 and age greater than 50 years were not found to be negative predictors of outcomes. Average patient-reported outcomes at 2 years' follow-up improved from preoperatively as follows: Lysholm score, from 50 to 82.9; WOMAC score, from 53.9 to 87.4; and VAS score, from 5.1 to 1.2. No serious complications were observed.
Patients undergoing posterior medial meniscal root reconstruction showed statistically significant improvements in Lysholm, WOMAC, SF-12 physical component summary, and VAS scores but not SF-12 mental component summary scores at short-term follow-up. No serious complications or clinical failures occurred, and no patients required revision surgery.
Level IV, case series.
描述采用自体股薄肌进行解剖学内侧半月板根部重建的患者报告的临床结局及并发症。
前瞻性收集2017年至2021年间接受关节镜下自体股薄肌内侧半月板根部重建患者的数据，并进行回顾性分析。纳入标准为有症状的后内侧半月板LaPrade 2型根部撕裂，任何膝关节腔软骨损伤不超过Outerbridge 2级，最短随访期为1年。排除有韧带不稳定的患者和有工伤赔偿情况的患者。前瞻性收集患者报告的结局（12项简短形式调查[SF - 12]、视觉模拟量表[VAS]、西安大略和麦克马斯特大学关节炎指数[WOMAC]以及Lysholm评分），并进行回顾性分析，在术前和术后各时间点进行评分和记录。使用三次样条回归模型分析数据。本研究经南卡罗来纳大学机构审查委员会批准。
对由单一外科医生治疗的连续27例患者进行了评估。纳入21例患者进行数据分析（4例因不符合标准被排除，2例失访），平均年龄48.1岁（范围16 - 63岁）。其中女性18例，男性3例。平均随访时间为25.2个月（范围12 - 42个月）。在所检查数据的术后时间点，发现Lysholm、WOMAC、VAS和SF - 12身体成分总结评分有统计学显著改善（<0.001，95%置信区间）。然而，SF - 12心理成分总结评分的改善未达到统计学显著水平（P = 0.262）。未发现体重指数大于35和年龄大于50岁是结局的负性预测因素。2年随访时患者报告的平均结局较术前改善如下：Lysholm评分从50提高到82.9；WOMAC评分从53.9提高到87.4；VAS评分从5.1降低到1.2。未观察到严重并发症。
接受后内侧半月板根部重建的患者在短期随访中，Lysholm、WOMAC、SF - 12身体成分总结和VAS评分有统计学显著改善，但SF - 12心理成分总结评分未改善。未发生严重并发症或临床失败情况，且无患者需要翻修手术。
IV级，病例系列。
