Itthipanichpong Thun, Choentrakool Chitapoom, Limskul Danaithep, Thamrongskulsiri Napatpong, Tanpowpong Thanathep, Virulsri Chanyaphan, Tangpornprasert Pairat, Kuptniratsaikul Somsak
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Knee Surg Sports Traumatol Arthrosc. 2025 Jun;33(6):2078-2085. doi: 10.1002/ksa.12513. Epub 2024 Oct 28.
To compare the load distributed to the medial tibial articular cartilage after refixation of posterior medial meniscus root tears between the suture anchor and transtibial pullout techniques in posterior medial meniscus root tears.
Twelve Thiel's embalmed human cadaveric knees are used and divided into three groups (four knees in each group): (1) intact meniscus (IM), (2) fixation with suture anchor technique (SA) and (3) fixation with transtibial pullout technique (TP). Each group applies an axial compression load up to 1500 N by Instron E 10000 at two knee flexion angles (0° and 60°). A Tekscan 4000 pressure sensor is used to record the contact pressure and the contact area for each testing condition.
The contact pressure and the contact area between the three conditions are not significantly different at 0° and 60° knee flexion angles. The peak contact pressure and contact area are 3734.8 ± 2642.2 kPa, 288.2 ± 115.0 mm, 4510 ± 2930.5 kPa, 204.4 ± 36.8 mm and 5328.8 ± 2607.7 kPa, 219.2 ± 84.7 mm in IM, SA and TP, respectively.
Both suture anchor and transtibial pullout refixation of PMMRT can restore contact pressure and contact area similar to the intact meniscus. This finding suggests that either technique can be reliably used in clinical practice to preserve joint function and potentially reduce the risk of osteoarthritis progression following posterior medial meniscus root tear repairs.
Level III.
比较后内侧半月板根部撕裂采用缝线锚钉技术和经胫骨拉出技术重新固定后,内侧胫骨关节软骨上分布的负荷情况。
使用12个经蒂尔氏防腐处理的人体尸体膝关节,分为三组(每组4个膝关节):(1)半月板完整组(IM),(2)采用缝线锚钉技术固定组(SA),(3)采用经胫骨拉出技术固定组(TP)。每组在两个膝关节屈曲角度(0°和60°)下通过英斯特朗E 10000施加高达1500 N的轴向压缩负荷。使用Tekscan 4000压力传感器记录每种测试条件下的接触压力和接触面积。
在膝关节屈曲角度为0°和60°时,三种情况之间的接触压力和接触面积无显著差异。IM组、SA组和TP组的峰值接触压力和接触面积分别为3734.8±2642.2 kPa、288.2±115.0 mm,4510±2930.5 kPa、204.4±36.8 mm和5328.8±2607.7 kPa、219.2±84.7 mm。
后内侧半月板根部撕裂采用缝线锚钉技术和经胫骨拉出技术重新固定均可恢复与完整半月板相似的接触压力和接触面积。这一发现表明,这两种技术在临床实践中均可可靠地用于保留关节功能,并可能降低后内侧半月板根部撕裂修复后骨关节炎进展的风险。
III级。