外侧半月板中段径向撕裂的全内侧缝合修复术后 24 周内观察到的外侧挤压明显小于内侧修复术后 24 周内观察到的外侧挤压

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2024-10-15 DOI:10.1002/jeo2.70041

Ryohei Uchida, Shuji Horibe, Yoshinari Tanaka, Akira Tsujii, Yuta Tachibana, Kazutaka Kinugasa, Yoshiki Shiozaki

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引用次数: 0

摘要

目的评估全内缝合（AIS）和经囊缝合（TCS）修复技术的术后半月板挤压情况。方法 13 名患者（平均年龄 19.4 岁）因外侧半月板中段径向撕裂（RTMLM）接受了仅使用缝线的 AIS 修复术（AIS 组），7 名患者（平均年龄 20.3 岁）接受了 TCS 内向外修复术（TCS 组）。所有病例的外侧半月板外侧（LE）、前侧（AE）和后侧（PE）半月板挤压情况均在术前和术后3周、12周和24周的磁共振成像中进行了测量。然后，以∆LE、∆AE和∆PE计算从术前到术后各个时期各挤压部位的变化。结果 AIS 组和 TCS 组在术前挤压方面无明显差异。至于术后挤压，只有 AIS 组的 ∆LEs 在术后所有时期都明显小于 TCS 组（术后 3 周为 -1.5 ± 1.7 vs. 0.9 ± 0.7 mm，术后 12 周为 -0.9 ± 0.9 vs. 0.4 ± 0.9 mm，术后 24 周为 -0.3 ± 1.0 vs. 0.6 ± 1.1 mm）。在 ∆AEs 和 ∆PEs 中，术后三个阶段均无显著差异。结论对 RTMLM 的 AIS 和 TCS 修复术后 MRI 上的 LE、AE 和 PE 进行了研究。与 TCS 修复术相比，AIS 修复 RTMLM 术后 24 周内观察到的侧向挤压明显较小，这可能会导致修复部位的稳定并防止退行性病变。证据等级病例对照研究，回顾性比较研究，Ⅲ级。

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Significantly smaller lateral extrusion was observed within 24 weeks after all-inside suture repairs of radial tear in the middle segment of lateral meniscus compared to inside-out repairs

Purpose

To evaluate the postoperative meniscal extrusion between all-inside suture (AIS) and trans-capsular suture (TCS) repair techniques.

Methods

Thirteen patients (mean age, 19.4 years) underwent AIS repairs using only sutures (AIS group) for radial tears in the middle segment of the lateral meniscus (RTMLM), and seven patients (mean age, 20.3 years) underwent inside-out repairs among TCS (TCS group). For all cases, lateral (LE), anterior (AE) and posterior (PE) meniscal extrusions of the lateral meniscus were measured during preoperative and 3-, 12- and 24-week postoperative MRIs. Then, the change of each extrusion from preoperative to each postoperative period was calculated as ∆LE, ∆AE and ∆PE.

Results

There was no significant difference between the AIS and TCS groups in the preoperative extrusions. As for postoperative extrusions, only ∆LEs in the AIS group was significantly smaller than those in the TCS group at all postoperative periods (−1.5 ± 1.7 vs. 0.9 ± 0.7 mm at 3-week, −0.9 ± 0.9 vs. 0.4 ± 0.9 mm at 12-week and −0.3 ± 1.0 vs. 0.6 ± 1.1 mm at 24-week postoperation). In ∆AEs and ∆PEs, at all three postoperative periods, there were no significant differences.

Conclusion

Postoperative LE, AE and PE on MRIs after AIS and TCS repairs for RTMLM were investigated. Significantly smaller lateral extrusion was observed within 24 weeks after AIS repairs of RTMLM compared to TCS repairs, which could lead to stabilization of the repair site and prevent degenerative changes.