Duprat François, Mouarbes Dany, Berard Emilie, Saoudi Samy, Lions Jean-Baptiste, Thomas Pierre, Faruch-Bilfeld Marie, Cavaignac Etienne
Department of Orthopedic Surgery and Trauma, Pierre-Paul Riquet Hospital, Toulouse, France.
Department of Orthopedic Surgery and Trauma, Pierre-Paul Riquet Hospital, Toulouse, France.
Orthop Traumatol Surg Res. 2025 Apr;111(2):104026. doi: 10.1016/j.otsr.2024.104026. Epub 2024 Oct 18.
Degenerative meniscal lesions (DML) are frequent in the general population. However, the management of stable DML is always a challenge due to the lack of universal consensus and evidence.
We assessed ultrasound-guided corticosteroids medial meniscal-wall infiltration as a conservative therapy for symptomatic DML and we searched for associated factors of very good response. Our hypothesis is that these injections will contribute to avoid the surgical treatment and improve clinical and functional scores.
An observational retrospective study included patients with DML of medial meniscus without mechanical symptoms of catching or locking, and without radiological signs of osteoarthritis, who underwent meniscal-wall corticoid infiltration under ultrasound between 2020 and 2021. Evaluations were carried-out at 24 months minimum after infiltration to determine any surgical intervention performed and assess clinical and functional outcome by a standard questionnaire to evaluate pain score using VAS at rest and on walking, SKV and TEGNER. Patient characteristics at the time of the infiltration were collected to determine the factors associated with very good response (SKV > 90).
187 patients were included. Surgery-free survival was 95% (90-97) (33,17 (SD, 6,40) months), mean VAS pain score at rest of 1.47 (SD, 2.51), mean VAS on walking of 2.47 (SD, 2.91), mean SKV score of 71.32 (SD, 22.75) and mean Tegner score of 6.75 (SD, 1.67) at a minimum of 24 months follow-up. BMI was significantly lower in the very good responders (SKV > 90) with a p = 0,017 (24.04 (SD, 3.82) in patients with SKV > 90 versus 26,23 (SD, 4.93) in patients with SVK ≤ 90).
US-guided meniscal wall infiltration is able to provide lasting symptom relief and functional recovery over time, in addition to low rate of conversion to surgery for patients suffering from DML without radiological signs of osteoarthritis.
IV; retrospective study.
退行性半月板损伤（DML）在普通人群中很常见。然而，由于缺乏普遍共识和证据，稳定型DML的治疗一直是一项挑战。
我们评估了超声引导下皮质类固醇内侧半月板壁浸润作为有症状DML的保守治疗方法，并寻找反应非常好的相关因素。我们的假设是，这些注射将有助于避免手术治疗并改善临床和功能评分。
一项观察性回顾性研究纳入了2020年至2021年间接受超声引导下半月板壁皮质类固醇浸润的内侧半月板DML患者，这些患者没有卡压或绞锁的机械症状，也没有骨关节炎的放射学征象。在浸润后至少24个月进行评估，以确定是否进行了任何手术干预，并通过标准问卷评估临床和功能结果，使用静息和行走时的视觉模拟评分（VAS）来评估疼痛评分、SKV和泰格纳评分。收集浸润时的患者特征，以确定与反应非常好（SKV>90）相关的因素。
纳入187例患者。无手术生存率为95%（90-97）（33.17（标准差，6.40）个月），静息时平均VAS疼痛评分为1.47（标准差，2.51），行走时平均VAS为2.47（标准差，2.91），至少随访24个月时平均SKV评分为71.32（标准差，22.75），平均泰格纳评分为6.75（标准差，1.67）。反应非常好（SKV>90）的患者体重指数显著较低，p=0.017（SKV>90的患者为24.04（标准差，3.82），而SVK≤90的患者为26.23（标准差，4.93））。
超声引导下半月板壁浸润能够随着时间的推移提供持久的症状缓解和功能恢复，对于没有骨关节炎放射学征象的DML患者，转换为手术的比例也较低。
IV；回顾性研究。
