Nishino Kazuya, Hashimoto Yusuke, Kinoshita Takuya, Iida Ken, Tsumoto Shuko, Nakamura Hiroaki
Department of Orthopaedic Surgery Osaka Metropolitan University Graduate School of Medicine Osaka Japan.
Osaka University of Health and Sport Sciences Graduate School of Sport Sciences Osaka Japan.
J Exp Orthop. 2024 Sep 30;11(4):e70028. doi: 10.1002/jeo2.70028. eCollection 2024 Oct.
This study investigated differences in the migration of meniscus sutured with pull-out sutures for treating medial meniscus posterior root tears (MMPRTs) according to the bone tunnel position, using cadaveric knees.
Six knees of three donors fixed using Thiel's method were included in this study. The MMPRTs were created, and a single suture was performed at the torn meniscus using an arthroscopic procedure. The suture was pulled out through the tibial bone tunnel, and the meniscus displacement was measured as the change in length during 0-120° of knee flexion. Three types of bone tunnels (anatomical, anterior and posterior) were created for each knee, and the sutures were pulled out of each tunnel three times. After completing all measurements, the proximal tibia was extracted and micro-computed tomography was performed to evaluate the tunnel position.
A significantly smaller change in suture length was observed in the posterior group compared to the other two groups (anatomical group, 5.17 ± 1.8 mm; anterior group, 7.50 ± 3.2 mm; posterior group, 1.17 ± 1.0 mm; > 0.01). In addition, a significant correlation between the anteroposterior tunnel position and suture length change was observed ( = -0.720; = 0.001).
When pull-out sutures were used to repair MMPRTs, the suture length change was approximately 5 mm during knee flexion and extension when the bone tunnel was located at the anatomical attachment site. This change was larger when the tunnel position was anterior, and smaller when the tunnel position was posterior.
LEVEL Ⅲ case-control study.
本研究使用尸体膝关节，根据骨隧道位置，调查采用拉出式缝线缝合治疗内侧半月板后根撕裂（MMPRT）时半月板移位的差异。
本研究纳入了3名供体的6个使用蒂尔方法固定的膝关节。制造MMPRT，并采用关节镜手术在撕裂的半月板处进行单针缝合。缝线通过胫骨骨隧道拉出，半月板移位通过膝关节在0-120°屈曲过程中的长度变化来测量。为每个膝关节制造三种类型的骨隧道（解剖型、前侧型和后侧型），缝线从每个隧道拉出三次。完成所有测量后，取出胫骨近端并进行微型计算机断层扫描以评估隧道位置。
与其他两组相比，后侧组的缝线长度变化明显更小（解剖型组，5.17±1.8毫米；前侧型组，7.50±3.2毫米；后侧型组，1.17±1.0毫米；P＞0.01）。此外，观察到前后隧道位置与缝线长度变化之间存在显著相关性（r=-0.720；P=0.001）。
当使用拉出式缝线修复MMPRT时，当骨隧道位于解剖附着部位时，膝关节屈伸过程中缝线长度变化约为5毫米。当隧道位置在前侧时，这种变化更大，而当隧道位置在后侧时，这种变化更小。
Ⅲ级病例对照研究。
