Division of Sports Medicine, Midwest Orthopaedics at Rush, 1611 W Harrison St, Chicago, IL, 60612, USA.
University of Cincinnati College of Medicine, Cincinnati, OH, 45219, USA.
Knee Surg Sports Traumatol Arthrosc. 2023 Oct;31(10):4474-4484. doi: 10.1007/s00167-023-07461-5. Epub 2023 Jul 30.
To perform a systematic review of biomechanical and clinical outcomes following lateral meniscus posterior root (LMPR) repair with concomitant anterior cruciate ligament reconstruction (ACLR).
A literature search was performed systematically using PubMed, Embase, and Medline databases in April 2022. The search included the following terms combined with Boolean operators: 'Meniscus repairs', 'Meniscal Repair', 'Posterior Horn', 'Root', 'Radial'. Inclusion criteria consisted of level I-IV human clinical and biomechanical studies reporting biomechanical data and/or outcomes following LMPR repair in the setting of ACLR.
Three biomechanical studies, all utilizing a transtibial pullout technique, were identified, all of which reported significant improvement in joint contact pressures and mechanics and 3/4 of which reported significant improvement in anterior or rotational stability with LMPR repair. Five clinical studies, consisting of 146 patients (mean age 28.5 ± 1.1 years) undergoing LMPR repair, were identified with an average follow-up of 19.1 months (range 6.2-46 months). Across all clinical studies, Lysholm and International Knee Documentation Committee (IKDC) scores were found to improve postoperatively, with 3/4 reporting significant improvement in Lysholm (all, p ≤ 0.001) scores and 3/5 reporting significant improvement in IKDC scores when compared to preoperative values (all, p ≥ 0.004). Meniscal extrusion decreased significantly following repair in 2/4 studies (all, p ≤ 0.001).
Biomechanically, transtibial pullout repair of the LMPR restored joint contact pressures and joint mechanics to intact levels when performed with concomitant ACLR. Clinically, LMPR repair with concurrent ACLR resulted in improved Lysholm and IKDC scores. These findings enable surgeons to determine optimal treatment plans and discuss realistic outcomes with patients when encountering LMPR injuries.
IV.
对合并前交叉韧带重建（ACLR）的外侧半月板后根（LMPR）修复后的生物力学和临床结果进行系统评价。
2022 年 4 月，我们通过 PubMed、Embase 和 Medline 数据库系统地进行了文献检索。搜索词包括以下术语，并使用布尔运算符进行组合：“半月板修复”、“半月板修复”、“后角”、“根”、“放射状”。纳入标准包括报告 ACLR 背景下 LMPR 修复后生物力学数据和/或结果的 I 至 IV 级人体临床和生物力学研究。
确定了 3 项生物力学研究，均采用经胫骨牵拉技术，所有研究均报告关节接触压力和力学显著改善，其中 3/4 项报告 LMPR 修复后前向或旋转稳定性显著改善。确定了 5 项临床研究，共纳入 146 例患者（平均年龄 28.5±1.1 岁），平均随访时间为 19.1 个月（6.2-46 个月）。在所有临床研究中，Lysholm 和国际膝关节文献委员会（IKDC）评分术后均有所改善，其中 3/4 项 Lysholm 评分（均，p≤0.001）显著改善，3/5 项 IKDC 评分（均，p≥0.004）与术前相比显著改善。在 2/4 项研究中，修复后半月板挤出明显减少（均，p≤0.001）。
生物力学上，经胫骨牵拉修复 LMPR 与同时进行的 ACLR 一起可使关节接触压力和关节力学恢复到完整水平。临床上，LMPR 修复联合 ACLR 可改善 Lysholm 和 IKDC 评分。这些发现使外科医生能够在遇到 LMPR 损伤时为患者确定最佳治疗方案并讨论现实结果。
IV。
