Okazaki Yuki, Sugiu Kazuhisa, Kamatsuki Yusuke, Tamura Masanori, Kawada Koki, Hasegawa Tsubasa, Furumatsu Takayuki
Department of Orthopaedic Surgery Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan.
Department of Orthopaedic Surgery Okayama Red Cross Hospital Okayama Japan.
J Exp Orthop. 2025 May 7;12(2):e70262. doi: 10.1002/jeo2.70262. eCollection 2025 Apr.
This study assessed the clinical outcomes of the FasT-Fix dependent modified Mason-Allen suture (F-MMA) and two simple stitches (TSS) on mid-term postoperative outcomes following medial meniscus (MM) posterior root repair.
Forty-three patients who underwent transtibial pullout repair for MM posterior root tear (PRT) between November 2016 and September 2018 were initially enrolled. Patients with a femorotibial angle ≤ 180°, Kellgren-Lawrence grade of 0-2, and modified Outerbridge grade I or II cartilage lesions were included. The Lysholm, Tegner activity, International Knee Documentation Committee score, pain visual analogue scale and Knee injury and Osteoarthritis Outcome scores were assessed as clinical outcomes. Conversion surgery to knee arthroplasty was considered as the endpoint. Surgeries other than second-look arthroscopy and plate or screw removal were also recorded.
The mean follow-up period was 5.9 years. All evaluated 5-year postoperative clinical outcomes were significantly improved compared to the preoperative outcomes ( < 0.001). Both the F-MMA and TSS significantly improved all clinical scores at 5 years postoperatively in patients with MMPRT, whereas the F-MMA and TSS groups showed no significant differences in the pre- and postoperative clinical scores. None of the patients required ipsilateral knee arthroplasty during the follow-up, and the survival rate after pullout repair was 100%. However, the progression of osteoarthritis could not be completely suppressed, although there were no Kellgren-Lawrence grade 4 cases. The rate of subsequent knee-related surgical treatment was 11.6% in pullout-repaired knees, including arthroscopic debridement for arthrofibrosis with a limited range of motion, an additional all-inside suture repair and partial meniscectomy.
Both F-MMA and TSS pullout repairs yielded satisfactory clinical outcomes in patients with MMPRT with a mean follow-up of 5.9 years, and no conversion to knee arthroplasty was required. Further follow-up is warranted to assess long-term survival rates.
Level III.
本研究评估了FasT-Fix依赖改良梅森-艾伦缝线（F-MMA）和两种简单缝线（TSS）在内侧半月板（MM）后根修复术后中期的临床疗效。
最初纳入了2016年11月至2018年9月间接受经胫骨拉出修复术治疗MM后根撕裂（PRT）的43例患者。纳入股骨胫骨角≤180°、凯尔格伦-劳伦斯分级为0-2级以及改良Outerbridge分级为I级或II级软骨损伤的患者。将Lysholm评分、Tegner活动度评分、国际膝关节文献委员会评分、疼痛视觉模拟量表评分和膝关节损伤与骨关节炎疗效评分作为临床疗效指标。将转为膝关节置换手术视为终点。还记录了除二次关节镜检查和取出钢板或螺钉以外的其他手术。
平均随访期为5.9年。与术前结果相比，所有评估的术后5年临床疗效均有显著改善（<0.001）。F-MMA和TSS均使MMPRT患者术后5年时的所有临床评分显著改善，而F-MMA组和TSS组术前和术后临床评分无显著差异。随访期间无患者需要同侧膝关节置换，拉出修复后的生存率为100%。然而，尽管没有凯尔格伦-劳伦斯4级病例，但骨关节炎的进展无法完全抑制。拉出修复膝关节的后续膝关节相关手术治疗率为11.6%，包括因关节活动范围受限而行关节镜下关节纤维性粘连清创术、额外的全内缝线修复术和部分半月板切除术。
F-MMA和TSS拉出修复术在平均随访5.9年的MMPRT患者中均产生了满意的临床疗效，且无需转为膝关节置换术。有必要进行进一步随访以评估长期生存率。
III级。
