Department of Orthopedics and Traumatology, Ankara Güven Hospital, Yüksek İhtisas University, Ankara, Turkey.
Department of Orthopedics and Traumatology, Medical Park Ankara Hospital, Yüksek İhtisas University, Ankara, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2024 Aug;32(8):2052-2060. doi: 10.1002/ksa.12303. Epub 2024 May 30.
The aim of this study was to evaluate how the pie-crusting technique affects clinical and radiological outcomes in patients undergoing arthroscopic partial meniscectomy.
A total of 68 patients with Kellgren-Lawrence (K-L) grade 2 who underwent arthroscopic partial meniscectomy between 2015 and 2021 were evaluated and divided into two groups as arthroscopic partial meniscectomy (36 patients) and arthroscopic partial meniscectomy with pie-crusting (32 patients) according to whether the pie-crusting technique was applied or not. All patients were evaluated at a minimum 2-year follow-up in terms of Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score and Visual Analogue Scale (VAS) score. To assess the impact of the pie-crusting technique, radiological measurements were conducted using radiographs taken before and after pie-crusting, as well as postoperative radiographs.
Lysholm, Tegner, IKDC and VAS scores exhibited statistically significant differences after surgery compared to preoperative evaluations in both groups (p < 0.05). Furthermore, these scores were significantly superior in the arthroscopic partial meniscectomy with pie-crusting group compared to the arthroscopic partial meniscectomy group at 24 months postoperatively (p < 0.05). While the radiological measurements in the arthroscopic partial meniscectomy with pie-crusting group showed statistically significant differences before and after pie-crusting (p < 0.05), no significant difference was observed between before pie-crusting and 12 and 24 months postoperatively (n.s.).
The current study is the first to demonstrate the true effectiveness of the pie-crusting technique. The application of the pie-crusting technique when necessary results in a statistically significant improvement in clinical scores without affecting radiological measurements for patients undergoing arthroscopic partial meniscectomy compared to not utilising it.
Level III.
本研究旨在评估 Pie-crusting 技术在接受关节镜下半月板部分切除术的患者的临床和影像学结果中的作用。
对 2015 年至 2021 年间接受关节镜下半月板部分切除术的 68 例 Kellgren-Lawrence（K-L）分级 2 级患者进行评估，并根据是否应用 Pie-crusting 技术将其分为关节镜下半月板部分切除术组（36 例）和关节镜下半月板部分切除术+ Pie-crusting 组（32 例）。所有患者均在至少 2 年的随访中进行 Lysholm 评分、Tegner 活动评分、国际膝关节文献委员会（IKDC）评分和视觉模拟评分（VAS）评估。为了评估 Pie-crusting 技术的影响，使用术前、术后和术后 Pie-crusting 后的 X 线片进行了影像学测量。
两组患者术后 Lysholm、Tegner、IKDC 和 VAS 评分与术前相比均有统计学意义（p<0.05）。此外，在术后 24 个月时，关节镜下半月板部分切除术+ Pie-crusting 组的这些评分明显优于关节镜下半月板部分切除术组（p<0.05）。关节镜下半月板部分切除术+ Pie-crusting 组的影像学测量在 Pie-crusting 前后有统计学意义（p<0.05），但在 Pie-crusting 前与术后 12 个月和 24 个月之间无统计学意义（n.s.）。
本研究首次证明了 Pie-crusting 技术的真正有效性。在需要时应用 Pie-crusting 技术可显著改善临床评分，而对接受关节镜下半月板部分切除术的患者的影像学测量无影响，与不应用 Pie-crusting 技术相比。
III 级。
