Li Jun, Shen Pengfei, Zou Tao, Min Wen, Qu Yuxing, Xie Zikang, Wei Chengjian
Changzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Department of Orthopedics, Changzhou, 213000, PR China.
Jiangsu Province Hospital of Traditional Chinese Medicine, Department of Orthopedics, Nanjing, 210000, PR China.
J Orthop. 2024 Dec 16;65:78-85. doi: 10.1016/j.jor.2024.12.003. eCollection 2025 Jul.
Medial meniscus posterior root tears (MMPRTs) significantly contribute to knee dysfunction, leading to abnormal biomechanics and accelerated cartilage degeneration. Arthroscopic transtibial pullout and all-inside repair are two commonly used techniques for treating MMPRTs, each with unique advantages and limitations.
To compare the clinical and functional outcomes of the transtibial pullout and all-inside repair techniques in the treatment of MMPRTs, with a focus on postoperative recovery, knee function, and complications.
40 patients with MMPRTs were randomized to undergo either the transtibial pullout or all-inside repair technique. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score, Tegner activity scale, Lysholm score, and active range of motion (AROM) of knee flexion, both before and after surgery. Data on operative time, time to ambulation, hospital stay duration, and complications were also collected.
Both surgical groups showed significant improvements in clinical outcomes postoperatively (p < 0.001). The transtibial group exhibited greater functional recovery, with IKDC, Tegner, and Lysholm scores improving by approximately 60 %, 110 %, and 68 %, respectively, compared to the all-inside group. However, complications were more frequent in the transtibial group, including three cases of wound healing issues and one infection, while the all-inside group had one case of deep vein thrombosis. No re-tears were observed in either group during follow-up.
Both the transtibial pullout and all-inside repair techniques effectively restore knee function in patients with MMPRTs. While the transtibial pullout provides better functional outcomes, it is associated with a higher complication rate. The choice of surgical approach should consider patient-specific factors, including tear characteristics and overall health, to optimize results.
内侧半月板后根部撕裂（MMPRTs）是导致膝关节功能障碍的重要原因，会引起生物力学异常并加速软骨退变。关节镜下经胫骨拉出修复术和全内修复术是治疗MMPRTs的两种常用技术，每种技术都有其独特的优缺点。
比较经胫骨拉出修复术和全内修复术治疗MMPRTs的临床和功能结果，重点关注术后恢复、膝关节功能和并发症。
40例MMPRTs患者被随机分为接受经胫骨拉出修复术或全内修复术。使用国际膝关节文献委员会（IKDC）评分、Tegner活动量表、Lysholm评分以及术前和术后膝关节屈曲的主动活动范围（AROM）来评估临床结果。还收集了手术时间、下地行走时间、住院时间和并发症的数据。
两个手术组术后临床结果均有显著改善（p < 0.001）。与全内修复组相比，经胫骨修复组功能恢复更好，IKDC、Tegner和Lysholm评分分别提高了约60%、110%和68%。然而，经胫骨修复组并发症更常见，包括3例伤口愈合问题和1例感染，而全内修复组有1例深静脉血栓形成。随访期间两组均未观察到再次撕裂。
经胫骨拉出修复术和全内修复术均能有效恢复MMPRTs患者的膝关节功能。虽然经胫骨拉出修复术功能结果更好，但并发症发生率更高。手术方法的选择应考虑患者的具体因素，包括撕裂特征和整体健康状况，以优化治疗效果。
