Jeon Sang Woo, Choi Chong Hyuk, Kim Sung-Hwan, Kim Sung-Jae, Kang Kyutae, Jung Min
Department of Orthopaedic Surgery, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea.
Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
J Clin Med. 2023 Feb 10;12(4):1439. doi: 10.3390/jcm12041439.
The extent to which resection of unstable leaf should be performed in horizontal cleavage meniscus tear has not yet been elucidated. The purpose of this study was to compare the clinical outcomes of partial meniscectomy for horizontal cleavage tear of medial meniscus between complete resection of inferior leaf including the periphery up to the joint capsule and partial resection leaving stable peripheral torn meniscal tissue. A total of 126 patients who underwent partial meniscectomy for horizontal cleavage tear of medial meniscus were divided into two groups: group C ( = 34), treated with the complete resection of the inferior leaf; and group P ( = 92), treated with partial resection of the inferior leaf. The minimum follow-up duration was 3 years. Functional outcomes were evaluated using the Lysholm knee scoring scale, International Knee Documentation Committee (IKDC) subjective knee evaluation form, and knee injury and osteoarthritis outcome score (KOOS). Radiologic assessments were performed using the IKDC radiographic assessment scale and measurement of the height of the joint space in the medial compartment of the tibiofemoral joint. The functional outcomes including the Lysholm knee, IKDC subjective score, activities of daily living and sport and recreation subscale of KOOS were worse in group C than in group P ( < 0.001). The radiologic outcomes including postoperative IKDC radiographic scale ( = 0.003) and the postoperative joint space on the affected side ( < 0.001) were also worse in group C than in group P. In the horizontal cleavage tear of medial meniscus, complete resection of the inferior leaf including the periphery up to the joint capsule showed inferior clinical outcomes compared with partial resection leaving stable peripheral rim of torn meniscus at minimum 3-year follow-up. If the peripheral part of the inferior leaf is stable in horizontal cleavage tear of medial meniscus, partial resection of the inferior leaf preserving peripheral rim can be recommended.
在水平劈裂半月板撕裂中，不稳定半月板瓣的切除范围尚未明确。本研究的目的是比较内侧半月板水平劈裂撕裂部分半月板切除术的临床结果，其中一组是完全切除包括直至关节囊边缘的下半月板瓣，另一组是保留稳定的周边撕裂半月板组织进行部分切除。共有126例行内侧半月板水平劈裂撕裂部分半月板切除术的患者被分为两组：C组（n = 34），接受下半月板瓣完全切除术；P组（n = 92），接受下半月板瓣部分切除术。最短随访时间为3年。使用Lysholm膝关节评分量表、国际膝关节文献委员会（IKDC）主观膝关节评估表和膝关节损伤与骨关节炎疗效评分（KOOS）评估功能结果。使用IKDC放射学评估量表和测量胫股关节内侧间隙高度进行放射学评估。C组的功能结果包括Lysholm膝关节评分、IKDC主观评分、KOOS的日常生活活动以及运动和娱乐子量表均比P组差（P < 0.001）。C组的放射学结果包括术后IKDC放射学量表（P = 0.003）和患侧术后关节间隙（P < 0.001）也比P组差。在内侧半月板水平劈裂撕裂中，在至少3年的随访中，完全切除包括直至关节囊边缘的下半月板瓣与保留撕裂半月板稳定周边边缘的部分切除相比，临床结果较差。如果内侧半月板水平劈裂撕裂中下半月板瓣的周边部分稳定，可推荐保留周边边缘进行下半月板瓣部分切除。
