Deng Xing-Hao, Wang Jing-Song, Chen Zhong, Zeng Wei-Ke, Peng Hua-Ming, Yan Wan-Ting, Jiang Chuan, Song Bin, Li Wei-Ping, Zhang Zheng-Zheng
Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.
Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P. R. China.
Arthroscopy. 2025 Jun;41(6):1879-1892.e4. doi: 10.1016/j.arthro.2024.07.024. Epub 2024 Aug 10.
To enhance the understanding of histologic healing after repairing medial meniscal posterior root tears (MMPRTs) at an early stage, utilizing a goat model.
Eighteen adult goats, totaling 36 knee joints, were allocated into 3 groups (n = 12): sham group (Sham), root tear group (RT), and root tear with transosseous suture group (RTS). At 12- and 24-week intervals postsurgery, all the knees were harvested for imaging, macroscopic, histologic, and biomechanical assessments.
The intact root served as a meniscus-bone interface that connected the tibial and circular fibers of the meniscus with a bony insertion and a root-meniscus transition. A direct fibrous connection was displayed at the bony insertion proximal to the synovium in the RTS group, while the remaining regions of the root displayed indirect fibrous healing. The healing in the RT group was disjointed and reminiscent of scar tissue. The RTS group exhibited a more pronounced coronal extrusion compared to the Sham group (0.42 ± 0.09 vs 0.19 ± 0.02, P = .0012) but was improved relative to that of the RT group (0.49 ± 0.02, P = .0028). The failure load and stiffness of the RTS group were notably higher than those of the RT group, with a strength of 42.67% and a stiffness of 83.75% of the intact root. All the samples ruptured at the root-meniscus transitions.
The incomplete healing may be attributed to the histologic factors underlying the low healing rate and persistent medial meniscal extrusion. Notably, the region attached to the posterior cruciate ligament exhibited superior healing compared to other regions of the bony insertion in the repaired group. Conversely, the root-meniscus transition displayed discontinuity, representing a mechanical weakness in the healing process.
Modifications of bone tunnel positioning and suture placement could be undertaken in subsequent studies to enhance the healing of the root-meniscus transition.
利用山羊模型，增强对早期修复内侧半月板后根撕裂（MMPRTs）后组织学愈合的理解。
18只成年山羊，共36个膝关节，被分为3组（n = 12）：假手术组（Sham）、后根撕裂组（RT）和经骨缝合的后根撕裂组（RTS）。在术后12周和24周时，采集所有膝关节进行影像学、宏观、组织学和生物力学评估。
完整的后根作为半月板-骨界面，将半月板的胫骨纤维和环形纤维与骨插入点及后根-半月板过渡区相连。RTS组在滑膜近端的骨插入点处显示出直接的纤维连接，而后根的其余区域显示出间接的纤维愈合。RT组的愈合是不连续的，类似瘢痕组织。与假手术组相比，RTS组表现出更明显的冠状面挤压（0.42±0.09对0.19±0.02，P = 0.0012），但相对于RT组有所改善（0.49±0.02，P = 0.0028）。RTS组的失效载荷和刚度明显高于RT组，强度为完整后根的42.67%，刚度为83.75%。所有样本均在半月板-后根过渡区断裂。
愈合不完全可能归因于愈合率低和内侧半月板持续挤压的组织学因素。值得注意的是，在修复组中，与骨插入点的其他区域相比，附着于后交叉韧带的区域显示出更好的愈合。相反，半月板-后根过渡区显示出不连续性，这代表了愈合过程中的机械薄弱点。
在后续研究中可以对骨隧道定位和缝线放置进行改进，以促进半月板-后根过渡区的愈合。
