Thamrongskulsiri Napatpong, Pholkerd Pongsatorn, Limskul Danaithep, Tanpowpong Thanathep, Kuptniratsaikul Somsak, Itthipanichpong Thun
Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Orthopaedics, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Clin Orthop Surg. 2024 Dec;16(6):906-916. doi: 10.4055/cios24099. Epub 2024 Nov 15.
The medial meniscus posterior root tear is a common cause of knee osteoarthritis, often misdiagnosed. Surgical repair aims to restore knee biomechanics, with evolving techniques focusing on direct fixation. The objective of this study was to evaluate the clinical and radiographic outcomes of arthroscopic soft suture anchor repair, without utilizing the posterior portal technique, for medial meniscus posterior root tears over a 2-year follow-up period.
This is a retrospective study involving 32 patients, including 13 men and 19 women, with a mean age of 57 years and follow-up of 2 years. All tears were classified as LaPrade type 2 medial meniscus posterior root tears. The paired -test was used to compare the International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm score, as well as meniscus extrusion between preoperative and postoperative states. The Wilcoxon signed-rank test was utilized to compare the Kellgren-Lawrence (KL) grades. Healing rates were assessed on magnetic resonance imaging (MRI).
MRI revealed complete healing in 17 out of 32 knees (53.1%), partial healing in 12 knees (37.5%), and signs of retear in 3 knees (9.4%). At final follow-up, the mean IKDC and Lysholm scores were 57.4 ± 10.3 and 84.8 ± 11.3, respectively, showing significant improvement from preoperative values ( 0.001). There was also a significant reduction in medial meniscus extrusion postoperatively, decreasing from 4.1 ± 0.8 mm preoperatively to 3.6 ± 0.9 mm postoperatively ( = 0.002). Additionally, KL grades did not progress significantly during the 2-year follow-up period, as evidenced by median KL grades of 2 both preoperatively and postoperatively ( = 0.072).
Arthroscopic repair of medial meniscus posterior root tears using a soft suture anchor without a posterior portal yielded a high healing rate in MRI and favorable patient-reported outcomes in short-term follow-up duration.
内侧半月板后根撕裂是膝关节骨关节炎的常见病因，常被误诊。手术修复旨在恢复膝关节生物力学，目前技术不断发展，重点在于直接固定。本研究的目的是评估在不采用后入路技术的情况下，关节镜下软质缝合锚钉修复内侧半月板后根撕裂在2年随访期内的临床和影像学结果。
这是一项回顾性研究，纳入32例患者，其中男性13例，女性19例，平均年龄57岁，随访2年。所有撕裂均分类为LaPrade 2型内侧半月板后根撕裂。采用配对t检验比较国际膝关节文献委员会主观膝关节评分表（IKDC）和Lysholm评分，以及术前和术后的半月板挤压情况。采用Wilcoxon符号秩检验比较Kellgren-Lawrence（KL）分级。通过磁共振成像（MRI）评估愈合率。
MRI显示32例膝关节中有17例（53.1%）完全愈合，12例（37.5%）部分愈合，3例（9.4%）有再次撕裂迹象。在末次随访时，IKDC和Lysholm评分的平均值分别为57.4±10.3和84.8±11.3，与术前值相比有显著改善（P<0.001）。术后内侧半月板挤压也显著减少，从术前的4.1±0.8 mm降至术后的3.6±0.9 mm（P=0.002）。此外，在2年随访期内KL分级没有显著进展，术前和术后的KL分级中位数均为2（P=0.072）。
在不采用后入路的情况下，使用软质缝合锚钉进行关节镜下内侧半月板后根撕裂修复，在MRI上显示出较高的愈合率，且在短期随访中患者报告的结果良好。
