van Trommel M F, Simonian P T, Potter H G, Wickiewicz T L
Sports Medicine Service, New York Hospital-Cornell University Medical College, New York, USA.
Am J Sports Med. 1998 May-Jun;26(3):446-52. doi: 10.1177/03635465980260031901.
Fifty-one patients with meniscal repair using the outside-in technique were reassessed with second-look arthroscopic procedures (N = 15), arthrographic examination (N = 41), magnetic resonance imaging (N = 36), or a combination of these techniques. Forty-one medial and 10 lateral menisci were repaired. The average clinical follow-up was 15 months (range, 3 to 80). Forty-five of 51 patients had tears that were located in or extended into the posterior horn of the medial or lateral meniscus. Complete healing occurred in 23 menisci (45%), partial healing was observed in 16 (15 medial, 1 lateral) (32%), and no healing occurred in 12 (24%). Remarkably, in all 15 patients who had tears extending from the posterior to the middle third of the medial meniscus that were partially healed, it was always the posterior third that had not fully healed. This finding is statistically significant. In addition, the middle third of these menisci had not fully healed in five patients. No healing occurred in the two patients with tears in the posterior third of the medial meniscus. Poor healing with the outside-in technique was observed in patients with tears into the posterior horn of the medial meniscus. For tears in the middle and anterior portion of the medial meniscus, as well as all lateral meniscus tears, the outside-in technique is our current method of choice.
对51例采用由外向内技术进行半月板修复的患者，通过二次关节镜检查（n = 15）、关节造影检查（n = 41）、磁共振成像（n = 36）或这些技术的联合应用进行重新评估。修复了41个内侧半月板和10个外侧半月板。平均临床随访时间为15个月（范围3至80个月）。51例患者中有45例的撕裂位于内侧或外侧半月板后角或延伸至后角。23个半月板（45%）完全愈合，16个（15个内侧，1个外侧）（32%）观察到部分愈合，12个（24%）未愈合。值得注意的是，在所有15例内侧半月板撕裂从后角延伸至中1/3且部分愈合的患者中，始终是后1/3未完全愈合。这一发现具有统计学意义。此外，这些半月板的中1/3在5例患者中未完全愈合。内侧半月板后1/3撕裂的2例患者未愈合。内侧半月板后角撕裂的患者采用由外向内技术愈合较差。对于内侧半月板中前部的撕裂以及所有外侧半月板撕裂，由外向内技术是我们目前的首选方法。
