Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Eur J Orthop Surg Traumatol. 2024 May;34(4):2021-2029. doi: 10.1007/s00590-024-03889-8. Epub 2024 Mar 22.
We aimed to evaluate the longitudinal changes in medial meniscus extrusion (MME) and clinical scores at multiple time points up to 3 years after pullout repair for medial meniscus posterior root tears (MMPRTs).
This retrospective case series study included 64 patients who underwent pullout repair for MMPRTs and four MRI evaluations (preoperatively and at 3 months, 1 year, and 3 years postoperatively). MME was measured during the same time points. Clinical scores were assessed four times: preoperatively and at 1, 2, and 3 years postoperatively. Additionally, a multivariate analysis was performed on the change in MME (ΔMME) from the preoperative measurement point to 3 years postoperatively.
The ΔMME per month from the preoperative measurement point to 3 months postoperatively, from 3 months to 1 year postoperatively, and from 1 to 3 years postoperatively were 0.30, 0.05, and 0.01 mm/month, respectively. All clinical scores significantly improved 3 years postoperatively (p < 0.001). In a multiple regression analysis for ΔMME from the preoperative measurement point to 3 years postoperatively, sex significantly affected the outcome (p = 0.039).
Following pullout repair for MMPRTs with well-aligned lower extremities, although MME progression could not be entirely prevented, the rate of progression decreased over time, and clinical scores improved. In particular, MME progressed markedly during the first 3 months postoperatively. Additionally, sex had a significant influence on MME progression, suggesting that males may be able to expand the indications of pullout repair for MMPRTs.
我们旨在评估内侧半月板后根撕裂(MMPRT)经皮撬拨术后长达 3 年的多个时间点的内侧半月板挤压(MME)的纵向变化和临床评分。
本回顾性病例系列研究纳入了 64 例接受 MMPRT 经皮撬拨修复术的患者,共进行了 4 次 MRI 评估(术前和术后 3 个月、1 年和 3 年)。在相同的时间点测量 MME。临床评分在术前和术后 1、2、3 年共评估 4 次。此外,对从术前测量点到术后 3 年的 MME(ΔMME)变化进行了多变量分析。
从术前测量点到术后 3 个月、3 个月到 1 年和 1 年到 3 年,每月的 ΔMME 分别为 0.30、0.05 和 0.01mm/月。所有临床评分在术后 3 年均显著改善(p<0.001)。在从术前测量点到术后 3 年的 ΔMME 多变量回归分析中,性别对结果有显著影响(p=0.039)。
对于下肢对线良好的 MMPRT 经皮撬拨修复术后,虽然无法完全阻止 MME 的进展,但进展速度随时间逐渐减慢,临床评分改善。特别是在术后 3 个月内,MME 进展明显。此外,性别对 MME 的进展有显著影响,提示男性可能可以扩大 MMPRT 经皮撬拨修复术的适应证。