Sekiya Hitoshi, Takatoku Kenzo, Okami Hitoshi, Kanaya Yuji, Yanagisawa Kenta
Department of Orthopaedic Surgery, Shin-Kaminokawa Hospital, 2360 Kaminokawa, Kawachi‑gun, Tochigi, 3290611, Japan.
J Orthop Surg Res. 2025 Jan 31;20(1):123. doi: 10.1186/s13018-025-05535-3.
The current literature evaluating meniscectomy outcomes often mixes various tear patterns, failing to elucidate the impact of specific tear types on procedure results. Flap tears, which are prone to causing mechanical symptoms, require targeted research. This study aims to examine Lysholm scores following a meniscectomy for medial meniscus flap tears, to determine if extensive resections lead to poorer one-year outcomes, and to assess their impact on postoperative bone marrow lesion (BML) risk and medial meniscus extrusion (MME) width.
Patients undergoing arthroscopic meniscectomy for medial meniscal flap tears were classified into three groups: minimum resection, single leaf resection, and subtotal resection. Lysholm scores and medial joint space (MJS) width on Rosenberg view radiographs were measured preoperatively and one year postoperatively. BMLs and MMEs were assessed via MRI preoperatively and at 1, 3, 6, and 12 months postoperatively.
Fifty patients (mean age 60 ± 13 years) underwent meniscectomy: minimum resection in 21 (42%), single leaf in 23 (46%), and subtotal in 6 (12%). The Lysholm scores improved significantly, from 65.5 ± 17.6 to 93.4 ± 16.5 (n = 50) at 12 months in patients overall (p < 0.001), while MJS width decreased from 3.9 ± 0.7 mm to 3.5 ± 0.8 mm (p < 0.001). There were no significant differences in Lysholm scores or MJS widths among the three resection patterns. The occurrence rate of BMLs in the medial femoral condyle and tibial plateau increased post-surgery, peaking at 1 month, but then improved to near-baseline by 12 months. The occurrence rate of BMLs was higher in the single leaf and subtotal meniscectomy groups post-surgery, but declined across all groups by 12 months. Among the three groups with different resection patterns, MME width at 12 months was 2.7 ± 1.8 mm in the subtotal resection group, which was significantly larger than in the other groups.
Arthroscopic partial meniscectomy for flap tears yielded favorable 12-month outcomes. Larger resections were associated with greater BML incidence and greater MME width.
目前评估半月板切除术结果的文献常常将各种撕裂模式混在一起，未能阐明特定撕裂类型对手术结果的影响。容易引起机械性症状的瓣状撕裂需要针对性研究。本研究旨在检查内侧半月板瓣状撕裂行半月板切除术后的Lysholm评分，确定广泛切除是否会导致较差的一年期结果，并评估其对术后骨髓损伤（BML）风险和内侧半月板挤压（MME）宽度的影响。
因内侧半月板瓣状撕裂接受关节镜下半月板切除术的患者分为三组：最小切除组、单叶切除组和次全切除组。术前和术后一年测量Rosenberg位X线片上的Lysholm评分和内侧关节间隙（MJS）宽度。术前以及术后1、3、6和12个月通过MRI评估BML和MME。
50例患者（平均年龄60±13岁）接受了半月板切除术：21例（42%）为最小切除，23例（46%）为单叶切除，6例（12%）为次全切除。总体患者在12个月时Lysholm评分显著改善，从65.5±17.6提高到93.4±16.5（n = 50）（p < 0.001），而MJS宽度从3.9±0.7mm降至3.5±0.8mm（p < 0.001）。三种切除模式在Lysholm评分或MJS宽度上无显著差异。股骨内侧髁和胫骨平台BML的发生率术后增加，在1个月时达到峰值，但到12个月时改善至接近基线水平。单叶和次全半月板切除组术后BML的发生率较高，但到12个月时所有组均下降。在三种不同切除模式的组中，次全切除组12个月时的MME宽度为2.7±1.8mm，显著大于其他组。
关节镜下对瓣状撕裂行部分半月板切除术可获得良好的12个月结果。更大范围的切除与更高的BML发生率和更大的MME宽度相关。
