前交叉韧带重建时行内侧半月板切除术与术后胫骨前移相关：一项回顾性分析。
Medial Meniscectomy at the Time of ACL Reconstruction Is Associated With Postoperative Anterior Tibial Translation: A Retrospective Analysis.
作者信息
Fithian Andrew, Manoharan Aditya, Chapek Michael, Xie Virginia, Ghahremani Jacob, Culler Mckenzie, Watarastaporn Tanya, Khan Najeeb
机构信息
Southern California Permanente Medical Group, San Diego, California, USA.
Bernard J. Tyson School of Medicine, Pasadena, California, USA.
出版信息
Orthop J Sports Med. 2024 Aug 15;12(8):23259671241263096. doi: 10.1177/23259671241263096. eCollection 2024 Aug.
BACKGROUND
Medial meniscal pathology and management have not been associated with postoperative anterior tibial translation (ATT) after anterior cruciate ligament reconstruction (ACLR).
PURPOSE
The purpose of this study was to evaluate the role of medial meniscal injury and treatment on pre- and postoperative ATT in the setting of primary ACLR. More specifically, the association between repairable medial meniscal tears, medial meniscectomy, and postoperative ATT, along with rates of revision surgery, was examined.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
A retrospective review was performed for patients who underwent ACLR between January 1, 2010 and December 31, 2015 at a single center. Descriptive data were obtained from an institutional database for a total of 396 patients included in this study and followed for 1 year postoperatively. Statistical analysis was performed to examine associations of meniscal treatment with postoperative ATT measurements made by KT-1000 arthrometer.
RESULTS
A total of 243 patients underwent isolated ACLR with autograft, 72 patients underwent autograft ACLR and partial medial meniscectomy (MMx) (ACLR + MMx), and 81 patients underwent autograft ACLR and medial meniscal repair (MMR) (ACLR + MMR). Patients with ACLR + MMx had higher mean age and body mass index compared with patients in the other groups. Patients who underwent ACLR + MMx had greater postoperative side-to-side ATT compared with patients undergoing ACLR (1.55 mm vs 1.07 mm; = .04) or patients undergoing ACLR + MMR (1.55 mm vs 1.01 mm; = .03). The ACLR + MMx group was less likely to have symmetric (<3-mm side-to-side difference) postoperative ATT compared with the ACLR group (85% vs 93%; = .03). There was no difference in postoperative ATT between ACLR and ACLR + MMR. Postoperative return to the operating room was greater in the ACLR + MRR group compared with the ACLR + MMx group (21.9% vs 8.2%; = .05).
CONCLUSION
MMx at the time of ACLR led to higher postoperative ATT compared with isolated ACLR or ACLR + MMR.
背景
内侧半月板病变及其处理与前交叉韧带重建（ACLR）术后的胫骨前移（ATT）无关。
目的
本研究旨在评估内侧半月板损伤及治疗在初次ACLR中对术前和术后ATT的作用。更具体地说，研究可修复的内侧半月板撕裂、内侧半月板切除术与术后ATT之间的关联，以及翻修手术率。
研究设计
队列研究；证据等级为3级。
方法
对2010年1月1日至2015年12月31日在单一中心接受ACLR的患者进行回顾性分析。从机构数据库中获取描述性数据，本研究共纳入396例患者，并对其进行术后1年的随访。采用KT-1000关节测角仪对术后ATT测量值进行统计分析，以检验半月板治疗与之的关联。
结果
共有243例患者接受了自体移植单纯ACLR，72例患者接受了自体移植ACLR和部分内侧半月板切除术（MMx）（ACLR+MMx），81例患者接受了自体移植ACLR和内侧半月板修复术（MMR）（ACLR+MMR）。与其他组患者相比，ACLR+MMx组患者的平均年龄和体重指数更高。与接受ACLR的患者（1.55mm对1.07mm；P=.04）或接受ACLR+MMR的患者（1.55mm对1.01mm；P=.03）相比，接受ACLR+MMx的患者术后双侧ATT更大。与ACLR组相比，ACLR+MMx组术后双侧ATT对称（双侧差异<3mm）的可能性更低（85%对93%；P=.03）。ACLR组和ACLR+MMR组术后ATT无差异。与ACLR+MMx组相比，ACLR+MRR组术后再次手术的比例更高（21.9%对8.2%；P=.05）。
结论
与单纯ACLR或ACLR+MMR相比，ACLR时进行MMx会导致术后ATT更高。
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