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半月板水平撕裂的治疗预后因素。

Prognostic factors for the treatment of meniscus horizontal tear.

机构信息

Department of Orthopaedic Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1, Neungdong-Ro, Gwangjin-Gu, Seoul, 05030, Korea.

Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.

出版信息

Sci Rep. 2022 Oct 14;12(1):17293. doi: 10.1038/s41598-022-21599-1.

Abstract

Meniscus horizontal tears are usually degenerative. It could be asymptomatic and unrelated to knee symptoms. Therefore, there are controversies regarding treatment choices. The aim of this study was to evaluate factors that affect the results of non-surgical and surgical treatments for meniscus horizontal tears. We retrospectively studied 159 patients with meniscus horizontal tears with a minimum 2-year follow-up period. Patients were treated non-surgically or arthroscopically. The treatment results were dichotomized into success and failure. The factors considered were age, sex, joint line tenderness, mechanical symptoms, widest tear gap width on sagittal MRI, cartilage lesion grade, discoid meniscus, tear site, and joint alignment. Joint alignment and cartilage lesion grade were the factors that significantly influenced non-surgical treatment results. The widest tear gap width and cartilage lesion grade significantly affected arthroscopic surgery results. The mechanical symptoms did not show any significant relationship with either treatment result. In treating patients with meniscus horizontal tears, patients with varus alignment and advanced cartilage lesions should be informed of possible poor outcomes with non-surgical treatment. If the patient has a wide tear gap or minimal cartilage lesion, arthroscopic surgery would be a good treatment choice. The mechanical symptom was not an adequate factor for arthroscopic surgery.

摘要

半月板水平撕裂通常是退行性的。它可能无症状,与膝关节症状无关。因此,对于治疗选择存在争议。本研究旨在评估影响半月板水平撕裂非手术和手术治疗结果的因素。我们回顾性研究了 159 例半月板水平撕裂患者,随访时间至少 2 年。患者接受非手术或关节镜治疗。将治疗结果分为成功和失败。考虑的因素包括年龄、性别、关节线压痛、机械症状、矢状 MRI 上最宽的撕裂间隙宽度、软骨损伤程度、盘状半月板、撕裂部位和关节对线。关节对线和软骨损伤程度是影响非手术治疗结果的重要因素。最宽的撕裂间隙宽度和软骨损伤程度显著影响关节镜手术结果。机械症状与两种治疗结果均无显著关系。在治疗半月板水平撕裂患者时,对于存在内翻畸形和进展性软骨损伤的患者,应告知其非手术治疗可能效果不佳。如果患者撕裂间隙较宽或软骨损伤较小,则关节镜手术是一种较好的治疗选择。机械症状不是关节镜手术的充分因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9533/9568550/15bfede5a385/41598_2022_21599_Fig1_HTML.jpg

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