Takase Ryota, Ohsawa Takashi, Hashimoto Shogo, Kurihara Shingo, Yanagisawa Shinya, Hagiwara Keiichi, Kimura Masashi, Chikuda Hirotaka
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
Zenshukai Hospital Gunma Sports Medicine Research Center, Gunma, Japan.
Knee Surg Sports Traumatol Arthrosc. 2023 Nov;31(11):4895-4902. doi: 10.1007/s00167-023-07528-3. Epub 2023 Aug 13.
The long-term changes in the dynamics of the medial meniscus after transtibial pullout repair for medial meniscus posterior root tears (MMPRTs) are not completely understood. Thus, the aim of this study was to investigate the effects of transtibial pullout repair on MMPRTs and whether the effects would be sustained.
Nineteen knees with MMPRTs that were treated by trans-tibial pullout repair were enrolled in this study. Medial meniscus extrusion (MME) was measured by ultrasonography during knee extension (no weight-bearing with the knee at 0° extension: NW0°) and 90° flexion (no weight-bearing with the knee at 90° flexion: NW90°) with the patient in the supine position and with full weight-bearing (FW0°) preoperatively and at 3 and 12 months postoperatively. The clinical outcomes were assessed using the Knee Injury and Osteoarthritis Outcome Score, Lysholm score, and International Knee Documentation Committee score.
The difference in MME with NW0° was not statistically significant between the preoperative (3.4 ± 1.0 mm) and 12-month postoperative (3.7 ± 0.6 mm) time points. The MME with NW90° at 3 (2.1 ± 0.7 mm) and 12 months (2.9 ± 0.6 mm) postoperatively were significantly lower than the preoperative values (3.4 ± 0.8 mm) (P < 0.05). However, the value significantly increased from 3 to 12 months postoperatively (P < 0.05). The MME with FW0° at 12 months postoperatively (4.3 ± 0.6 mm) was significantly larger than that at pre-operatively (3.6 ± 0.9 mm) (P < 0.05). All the patients' clinical conditions were significantly improved at 12 months postoperatively when compared to their preoperative clinical conditions.
Surgery did not reduce the extrusion in the no weight-bearing and weight-bearing positions at knee extension, and these values increased in the postoperative period. In addition, while the surgery reduced the extrusion in the knee flexion position, the restoration achieved by the surgery was not sustained in the long term.
Level IV.
对于内侧半月板后根撕裂（MMPRTs）经胫骨拉出修复术后内侧半月板动力学的长期变化尚未完全了解。因此，本研究的目的是探讨经胫骨拉出修复对MMPRTs的影响以及这种影响是否会持续存在。
本研究纳入了19例接受经胫骨拉出修复治疗的MMPRTs患者的膝关节。在患者仰卧位且膝关节伸直（膝关节伸直0°无负重：NW0°）和屈曲90°（膝关节屈曲90°无负重：NW90°）时，以及术前和术后3个月及12个月全负重（FW0°）时，通过超声测量内侧半月板挤压（MME）。使用膝关节损伤和骨关节炎疗效评分、Lysholm评分和国际膝关节文献委员会评分评估临床结果。
术前（3.4±1.0mm）和术后12个月（3.7±0.6mm）时NW0°的MME差异无统计学意义。术后3个月（2.1±0.7mm）和12个月（2.9±0.6mm）时NW90°的MME显著低于术前值（3.4±0.8mm）（P<0.05）。然而，该值在术后3至12个月显著增加（P<0.05）。术后12个月FW0°的MME（4.3±0.6mm）显著大于术前（3.6±0.9mm）（P<0.05）。与术前临床状况相比，所有患者在术后12个月时的临床状况均有显著改善。
手术并未减少膝关节伸直时非负重和负重位置的挤压，且这些值在术后有所增加。此外，虽然手术减少了膝关节屈曲位置的挤压，但手术实现的恢复在长期内并未持续。
四级。
