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40岁以上患者的全关节镜下半月板修复:40岁是新的20岁吗?

All-Inside Arthroscopic Meniscus Repair for Patients Over 40 Years of Age: Is Forty the New Twenty?

作者信息

Ciapini Gianluca, Varchetta Giorgio, Bizzocchi Federico, Gadsby Giulio, Lombardi Leonardo, Sgadò Francesca, Ipponi Edoardo, Scaglione Michelangelo, Parchi Paolo Domenico

机构信息

Department of Orthopedics and Traumatology, University of Pisa, Pisa, ITA.

出版信息

Cureus. 2024 Mar 18;16(3):e56413. doi: 10.7759/cureus.56413. eCollection 2024 Mar.

Abstract

INTRODUCTION

Meniscal injuries are a common challenge in orthopedic surgery. For decades, partial or total meniscectomy has been the primary surgical treatment for meniscal tears. In recent years, the increased recognition of menisci's biomechanical importance has progressively shifted the paradigm towards meniscus repair. However, meniscus-sparing surgery remains the treatment of choice for selected lesions in young and active patients, especially for young and active patients. In this study, we evaluated the effectiveness of all-inside sutures in treating meniscus tears in patients over 40.

METHODS

In our retrospective evaluation, we evaluated the clinical and functional outcomes of cases over 40 years of age with post-traumatic acute meniscus tears that received meniscus repairs using the all-inside technique. The pre-operative and post-operative functionality of treated patients were assessed using the knee injury and osteoarthritis outcome score (KOOS) score. Major complications were recorded.

RESULTS

Twenty-three cases met our inclusion criteria. Eight females and fifteen males with a mean age of 44.9 were included in our study. Their mean follow-up was 35.1 months. Before surgery, our patients' mean KOOS score was 55.4 (18-80). At the patients' latest follow-up, the value had risen to 87.4 (63-100). There was no statistical correlation between patients' age and their functional recovery. No surgical failure was recorded at the latest follow-up.

CONCLUSION

The all-inside suture technique can represent a suitable and reliable solution for suturable meniscal tears, even for patients over 40. Preserving the meniscus and restoring patients' functionality allows patients to return to their daily activities and promote their quality of life.

摘要

引言

半月板损伤是骨科手术中常见的挑战。几十年来,部分或全半月板切除术一直是半月板撕裂的主要手术治疗方法。近年来,对半月板生物力学重要性的认识不断提高,逐渐将治疗模式转向半月板修复。然而,保留半月板的手术仍然是年轻活跃患者特定损伤的首选治疗方法,尤其是对于年轻活跃患者。在本研究中,我们评估了全内缝合治疗40岁以上患者半月板撕裂的有效性。

方法

在我们的回顾性评估中,我们评估了40岁以上创伤后急性半月板撕裂患者采用全内技术进行半月板修复的临床和功能结果。使用膝关节损伤和骨关节炎疗效评分(KOOS)对治疗患者的术前和术后功能进行评估。记录主要并发症。

结果

23例符合我们的纳入标准。我们的研究纳入了8名女性和15名男性,平均年龄为44.9岁。他们的平均随访时间为35.1个月。手术前,我们患者的平均KOOS评分为55.4(18 - 80)。在患者的最新随访中,该值已升至87.4(63 - 100)。患者年龄与功能恢复之间无统计学相关性。在最新随访中未记录到手术失败情况。

结论

全内缝合技术对于可缝合的半月板撕裂而言是一种合适且可靠的解决方案,即使对于40岁以上的患者也是如此。保留半月板并恢复患者功能可使患者恢复日常活动并提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a6e/11024730/0033cf3b910a/cureus-0016-00000056413-i01.jpg

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