内侧半月板后根修复的临床结果:至少5年的随访研究

IF 2 Q2 ORTHOPEDICS
Yuki Okazaki, Kazuhisa Sugiu, Yusuke Kamatsuki, Masanori Tamura, Koki Kawada, Tsubasa Hasegawa, Takayuki Furumatsu
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引用次数: 0

摘要

目的:本研究评估FasT-Fix依赖改良Mason-Allen缝线(F-MMA)和两缝线(TSS)对内侧半月板(MM)后根修复术后中期预后的临床效果。方法2016年11月至2018年9月,43例MM后根撕裂(PRT)患者行经胫骨拔出修复术。纳入股胫角≤180°、Kellgren-Lawrence分级为0-2级、改良的Outerbridge I级或II级软骨病变的患者。Lysholm, Tegner活动,国际膝关节文献委员会评分,疼痛视觉模拟量表和膝关节损伤和骨关节炎结局评分作为临床结果进行评估。转换手术到膝关节置换术被认为是终点。除二次关节镜检查和钢板或螺钉取出外的手术也有记录。结果平均随访时间为5.9年。与术前相比,所有评估的5年术后临床结果均有显著改善(p < 0.001)。F-MMA和TSS均可显著改善MMPRT患者术后5年的所有临床评分,而F-MMA和TSS组在术前和术后临床评分方面无显著差异。随访期间无一例患者需要行同侧膝关节置换术,拔出修复后生存率为100%。然而,骨关节炎的进展不能完全抑制,尽管没有Kellgren-Lawrence 4级病例。术后膝关节相关手术治疗的比例为11.6%,包括关节镜下清创治疗活动范围受限的关节纤维化,额外的全内缝合修复和部分半月板切除术。结论F-MMA和TSS拔除修复术对MMPRT患者均有满意的临床效果,平均随访5.9年,无需转膝关节置换术。有必要进一步随访以评估长期生存率。证据等级三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical outcomes following medial meniscus posterior root repairs: A minimum of 5-year follow-up study

Clinical outcomes following medial meniscus posterior root repairs: A minimum of 5-year follow-up study

Purpose

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.

Methods

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.

Results

The mean follow-up period was 5.9 years. All evaluated 5-year postoperative clinical outcomes were significantly improved compared to the preoperative outcomes (p < 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.

Conclusion

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 of Evidence

Level III.

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来源期刊
Journal of Experimental Orthopaedics
Journal of Experimental Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
3.20
自引率
5.60%
发文量
114
审稿时长
13 weeks
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