Tamura Masanori, Furumatsu Takayuki, Yokoyama Yusuke, Okazaki Yuki, Kawada Koki, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Okayama Red Cross Hospital, 2-1-1 Aoe, Kitaku, Okayama, 700-8607, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2024 Sep 23;38:29-35. doi: 10.1016/j.asmart.2024.09.003. eCollection 2024 Oct.
BACKGROUND/OBJECTIVE: The main surgical treatment for medial meniscus posterior root tear (MMPRT) has shifted from meniscectomy to meniscus repair; however, there is no clear consensus regarding the optimal postoperative management strategy after MMPRT repair. This study aimed to perform a comparative analysis of patients who received conventional rehabilitation or fast rehabilitation following MMPRT repair.
The current retrospective cohort study compared clinical, radiological, and arthroscopic outcomes after conventional rehabilitation (group A, January 2020 to April 2020, 24 patients) with those after fast rehabilitation (group B, May 2020 to August 2020, 24 patients) in patients who underwent pullout repair for MMPRT. Partial weight-bearing and range of motion exercises were allowed 2 weeks postoperatively in group A and 1 week postoperatively in group B. In patients with an average weight of approximately 60 kg, full weight bearing was allowed 4 weeks postoperatively in group A and 3 weeks postoperatively in group B.
At 12 months postoperatively, the clinical scores, including International Knee Documentation Committee and Japanese Knee Injury and Osteoarthritis Outcome Score, significantly improved in both groups (p < 0.01). Although meniscus healing was achieved in both groups, medial meniscus extrusion significantly progressed by 0.9 mm in group A and 0.8 mm in group B (p < 0.01, compared with preoperative extrusion). There were no significant differences in clinical scores, arthroscopic meniscal healing status, or medial meniscus extrusion progression on magnetic resonance images between the groups.
A fast rehabilitation protocol can be safely implemented without compromising patient outcomes after pullout repair for MMPRT.
背景/目的:内侧半月板后根撕裂(MMPRT)的主要手术治疗方式已从半月板切除术转变为半月板修复术;然而,对于MMPRT修复术后的最佳管理策略尚无明确共识。本研究旨在对MMPRT修复术后接受传统康复或快速康复的患者进行对比分析。
本回顾性队列研究比较了接受MMPRT拉出修复术的患者中,传统康复组(A组,2020年1月至2020年4月,24例患者)与快速康复组(B组,2020年5月至2020年8月,24例患者)术后的临床、影像学和关节镜检查结果。A组术后2周允许部分负重和进行活动度锻炼,B组术后1周允许。对于平均体重约60kg的患者,A组术后4周允许完全负重,B组术后3周允许。
术后12个月,两组的临床评分,包括国际膝关节文献委员会评分和日本膝关节损伤与骨关节炎疗效评分,均显著改善(p<0.01)。虽然两组均实现了半月板愈合,但A组内侧半月板挤出明显进展0.9mm,B组进展0.8mm(与术前挤出相比,p<0.01)。两组之间的临床评分、关节镜下半月板愈合状态或磁共振图像上内侧半月板挤出进展无显著差异。
对于MMPRT拉出修复术,快速康复方案可以安全实施,且不影响患者预后。