Jensen N C, Riis J, Robertsen K, Holm A R
Department of Orthopaedic Surgery, Horsens Hospital, Denmark.
Arthroscopy. 1994 Apr;10(2):211-4. doi: 10.1016/s0749-8063(05)80096-9.
Forty-nine patients underwent arthroscopic meniscal repair. Twenty-three had an isolated tear of the medial meniscus, four an isolated tear of the lateral meniscus, two a tear of the medial meniscus combined with a rupture of the medial collateral ligament, and 20 a tear of the anterior cruciate ligament (ACL) and a tear of one or both menisci. At the time of repair of the menisci, seven had undergone reconstruction of their ACL, whereas 13 had been treated conservatively for their ACL rupture. Seven of 10 retears were in patients with a conservatively treated ACL tear, and three were in patients with an isolated tear of a meniscus. Thirty-five patients without retears were reexamined after 5.5 years (1-6.3 years). The average Lysholm knee score before the trauma was 98 (range 75-100), and at follow-up it was 87 (range 29-100). The average Tegner's activity score before the trauma was 6 (range 3-9), and at follow-up it was 5 (range 0-9). When there is no retear, the clinical results of arthroscopic repair of the menisci are excellent. In those patients who had isolated lesions of the menisci, there were very few retears, 11% in this study. ACL deficiency of the knee greatly increases the risk of retear. In this study 46% of patients with persistent instability after an untreated ACL rupture incurred retears. There were no retears in the patients who underwent ACL reconstruction concomitant with the meniscal repair.
49例患者接受了关节镜下半月板修复术。其中23例为内侧半月板孤立性撕裂,4例为外侧半月板孤立性撕裂,2例为内侧半月板撕裂合并内侧副韧带断裂,20例为前交叉韧带(ACL)撕裂合并一侧或双侧半月板撕裂。在半月板修复时,7例患者已进行了ACL重建,而13例患者的ACL撕裂接受了保守治疗。10例再次撕裂患者中,7例为ACL撕裂接受保守治疗的患者,3例为半月板孤立性撕裂患者。35例未出现再次撕裂的患者在5.5年(1 - 6.3年)后接受了复查。创伤前平均Lysholm膝关节评分为98分(范围75 - 100分),随访时为87分(范围29 - 100分)。创伤前平均Tegner活动评分为6分(范围3 - 9分),随访时为5分(范围0 - 9分)。当没有再次撕裂时,关节镜下半月板修复的临床效果极佳。在那些半月板孤立性损伤的患者中,再次撕裂很少,本研究中为11%。膝关节ACL缺损会大大增加再次撕裂的风险。在本研究中,ACL撕裂未治疗后持续不稳定的患者中有46%发生了再次撕裂。半月板修复同时进行ACL重建的患者未出现再次撕裂。