Horita Kazushi, Kamiya Tomoaki, Shiwaku Kousuke, Mori Yuta, Hamaoka Kodai, Ikeda Yasutoshi, Okada Yohei, Emori Makoto, Watanabe Kota, Fujie Hiromichi, Teramoto Atsushi
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Sports Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Orthop J Sports Med. 2025 Aug 20;13(8):23259671251356695. doi: 10.1177/23259671251356695. eCollection 2025 Aug.
Evaluation of medial meniscal extrusion (MME) under physiological loads is crucial because of the influence of MME on meniscal function. Reducing the MME is essential for meniscal function. Few studies have compared the extent of MME in cases of complete radial tears of the posterior segment of the medial meniscus (MM) treated using basic meniscal repair techniques: the inside-out and all-inside techniques.
To compare the extent of MME after the treatment of complete radial tears of the posterior segment using inside-out and all-inside meniscal repair techniques in a cadaveric model.
Controlled laboratory study.
Six fresh-frozen human cadaveric knees were subjected to a compression load of 250 N using a 6 degrees of freedom robotic system under ultrasound evaluation. The MME was evaluated at 30° and 90° knee flexion in 4 meniscal conditions: (1) intact; (2) complete radial tear in the posterior segment of the MM; (3) inside-out repair technique; and (4) all-inside repair technique using 1 horizontal suture. Conditions 3 and 4 were performed on the same knee in a randomized order. Measurements were obtained at the center of the superficial medial collateral ligament (MCL) (central image) and 1 cm posterior to the superficial MCL (posterior image). Statistical analysis was conducted using a 2-factor repeated-measures analysis of variance with Bonferroni post-hoc correction, with significance level set at < .05.
The amount of MME under compression load after inside-out repair was significantly lower than that after all-inside repair (mean ± SD values for the central image: 30°, 1.93 ± 0.26 mm vs 2.45 ± 0.34 mm; 90°, 2.02 ± 0.29 mm vs 2.53 ± 0.42 mm; for the posterior image: 30°, 1.98 ± 0.30 mm vs 2.43 ± 0.35 mm; 90°, 2.45 ± 0.26 mm vs 3 ± 0.42 mm; < .001 for all comparisons).
Although the inside-out repair technique reduced the amount of MME to a greater extent than the all-inside repair technique using a single horizontal stitch for MM posterior segment tears, neither technique was able to reduce MME to the same level as that of the intact state; furthermore, the change in MME was relatively small.
The findings indicate that the inside-out repair technique should be used to repair complete radial tears in the posterior segment of the MM.
由于内侧半月板挤压（MME）对半月板功能有影响，因此在生理负荷下评估MME至关重要。减少MME对半月板功能至关重要。很少有研究比较使用基本半月板修复技术（由外向内技术和全内技术）治疗内侧半月板（MM）后段完全放射状撕裂病例中的MME程度。
在尸体模型中比较使用由外向内和全内半月板修复技术治疗后段完全放射状撕裂后MME的程度。
对照实验室研究。
使用六自由度机器人系统在超声评估下对六个新鲜冷冻的人体尸体膝关节施加250 N的压缩负荷。在4种半月板情况下，于膝关节屈曲30°和90°时评估MME：（1）完整；（2）MM后段完全放射状撕裂；（3）由外向内修复技术；（4）使用1条水平缝线的全内修复技术。情况3和4在同一膝关节上以随机顺序进行。在浅层内侧副韧带（MCL）中心（中央图像）和浅层MCL后方1 cm处（后方图像）进行测量。使用双因素重复测量方差分析并进行Bonferroni事后校正进行统计分析，显著性水平设定为<0.05。
由外向内修复后压缩负荷下的MME量显著低于全内修复后（中央图像的均值±标准差：30°时，1.93±0.26 mm对2.45±0.34 mm；90°时，2.02±0.29 mm对2.53±0.42 mm；后方图像：30°时，1.98±0.30 mm对2.43±0.35 mm；90°时，2.45±0.26 mm对3±0.42 mm；所有比较P<0.001）。
尽管对于MM后段撕裂，由外向内修复技术比使用单条水平缝线的全内修复技术在更大程度上减少了MME量，但两种技术均无法将MME减少到与完整状态相同的水平；此外，MME的变化相对较小。
研究结果表明，应由外向内修复技术用于修复MM后段的完全放射状撕裂。
