Gabr Ayman, Williams Samson, Dodd Sophie, Barton-Hanson Nick
Department of Trauma & Orthopaedics, West Suffolk Hospital, Suffolk IP33 2QZ, United Kingdom.
Department of Trauma and Orthopaedics, Alder Hey Children's Hospital, Liverpool L14 5AB, United Kingdom.
World J Orthop. 2024 Jun 18;15(6):547-553. doi: 10.5312/wjo.v15.i6.547.
Meniscal sparing surgery is a widely utilised treatment option for unstable meniscal tears with the aim of minimising the risk of progression towards osteoarthritis. However, there is limited data in the literature on meniscal repair outcomes in skeletally immature patients.
To evaluate the re-operation rate and functional outcomes of meniscal repairs in children and adolescents.
We performed a retrospective review of all patients who underwent arthroscopic meniscal repair surgery between January 2007 and January 2018. All patients were under the age of 18 at the time of surgery. Procedures were all performed by a single surgeon. Information was gathered from our hospital Electronic Patient Records system. The primary outcome measure was re-operation rate (need for further surgery on the same meniscus). Secondary outcome measures were surgical complications and patient reported outcome measures that were International Knee Documentation Committee (IKDC), Tegner and Lysholm scores.
We identified 59 patients who underwent 66 All-inside meniscal repairs (32 medial meniscus and 34 Lateral meniscus). Meniscal repairs were performed utilizing FasT-Fix (Smith and Nephew) implants. There were 37 males and 22 females with an average age of 14 years (range 6-16). The average follow-up time was 53 months (range 26-140). Six patients had concomitant anterior cruciate ligament reconstruction surgery along with the meniscal repair. There were no intra-operative complications. The re-operation rate for meniscal repairs was 16.6% (11 cases) with 2 patients requiring further meniscal repairs and 9 patients underwent partial meniscectomies. The mean postoperative IKDC score was 88 (44-100), Tegner score was 7(2-10) and Lysholm score was 94 (57-100).
Our results showed that arthroscopic repair of meniscal tears in the paediatric population is an effective treatment option that has a low failure rate and good postoperative clinical with the advantage of preserving meniscal tissues.
半月板保留手术是治疗不稳定半月板撕裂的一种广泛应用的治疗选择，目的是将发展为骨关节炎的风险降至最低。然而，关于骨骼未成熟患者半月板修复结果的文献数据有限。
评估儿童和青少年半月板修复的再次手术率和功能结果。
我们对2007年1月至2018年1月期间接受关节镜下半月板修复手术的所有患者进行了回顾性研究。所有患者在手术时年龄均未满18岁。手术均由一名外科医生进行。信息从我们医院的电子病历系统中收集。主要结局指标是再次手术率（同一半月板需要进一步手术）。次要结局指标是手术并发症以及患者报告的结局指标，即国际膝关节文献委员会（IKDC）、Tegner和Lysholm评分。
我们确定了59例接受66次全内半月板修复手术的患者（32例内侧半月板和34例外侧半月板）。半月板修复使用FasT-Fix（施乐辉）植入物进行。有37名男性和22名女性，平均年龄14岁（范围6-16岁）。平均随访时间为53个月（范围26-140个月）。6例患者在半月板修复的同时进行了前交叉韧带重建手术。术中无并发症。半月板修复的再次手术率为16.6%（11例），其中2例患者需要进一步半月板修复，9例患者接受了部分半月板切除术。术后IKDC评分平均为88分（44-100分），Tegner评分为7分（2-10分），Lysholm评分为94分（57-100分）。
我们的结果表明，儿童人群关节镜下半月板撕裂修复是一种有效的治疗选择，失败率低，术后临床效果良好，具有保留半月板组织的优势。
