联合前交叉韧带重建和外侧半月板根修复与孤立前交叉韧带重建相比失败率低，但主观结果较差：独立隧道和前交叉韧带骨隧道技术的比较研究

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-04 DOI:10.1002/jeo2.70405

Christoffer von Essen, Riccardo Cristiani, Björn Barenius, Anders Stålman

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引用次数: 0

摘要

目的评价前交叉韧带重建（ACLR）联合半月板外侧根撕裂（LMRT）修复的功能和主观效果。此外，比较使用独立隧道进行LMRT修复与ACL骨隧道技术，并评估LMRT修复孤立ACLR的失败率。方法回顾性分析2017年5月至2022年5月在瑞典斯德哥尔摩Capio Artro诊所接受原发性ACLR和伴行LMRT修复的患者，并将其与同期接受孤立ACLR的患者进行1:3匹配（年龄、性别和移植物类型）。术前和6个月时评估功能结果，包括活动范围（ROM）、膝关节前侧松弛度和等速力量，2年时评估膝关节损伤和骨关节炎结局评分（oos）。LMRT修复失败定义为在随访期间需要再次手术并切除半月板。结果共纳入84例患者，平均年龄（31.1±11.1）岁，男性61.9%。LMRT修复失败率为7.1%。隧道技术在关节活动度、松弛度和强度方面没有显著差异。2年时，ACLR + LMRT组的KOOS评分在疼痛（86.1±15.2比91.3±13.3,p = 0.039）、症状（79.3±19.1比86.3±17.3,p = 0.017）、运动（69.2±26.4比82.1±25.3,p = 0.017）和生活质量（61.2±25.3比75.3±26.2,p = 0.03）方面均显著低于单纯ACLR组。LMRT组中只有29.2%的患者达到了患者可接受的症状状态（PASS），而孤立ACLR组为65.2% （p < 0.01）。结论ACLR + LMRT联合修复失败率为7.1%。然而，与孤立ACLR相比，添加LMRT修复的主观结果较低。使用独立胫骨隧道进行LMRT修复并不比共享ACL隧道技术具有额外的临床益处。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。

Combined anterior cruciate ligament reconstruction and lateral meniscal root repair yields low failure rates, but inferior subjective outcomes compared to isolated anterior cruciate ligament reconstruction: A comparative study of independent tunnel and anterior cruciate ligament bone tunnel techniques

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Purpose

To assess the functional and subjective outcomes of combined anterior cruciate ligament reconstruction (ACLR) and lateral meniscal root tear (LMRT) repair. Additionally, to compare the use of an independent tunnel for LMRT repair with the ACL bone tunnel technique and to assess the failure rates of LMRT repair to isolated ACLR.

Methods

Patients who underwent primary ACLR and concomitant LMRT repair from May 2017 to May 2022 at Capio Artro Clinic, Stockholm, Sweden, were retrospectively identified and matched 1:3 (age, sex and graft type) with patients who underwent isolated ACLR during the same period. Functional outcomes, including range of motion (ROM), anterior knee laxity and isokinetic strength, were assessed preoperatively and at 6 months, and the knee injury and osteoarthritis outcome score (KOOS) at 2 years. Failure of LMRT repair was defined as the need for reoperation with meniscal resection during the follow-up period.

Results

A total of 84 patients were included (mean age 31.1 ± 11.1 years; 61.9% male). LMRT repair failure occurred in 7.1% of cases. No significant differences were observed between tunnel techniques in ROM, laxity, or strength. At 2 years, KOOS scores were significantly lower in the ACLR + LMRT group compared to the isolated ACLR group in pain (86.1 ± 15.2 vs. 91.3 ± 13.3, p = 0.039), symptoms (79.3 ± 19.1 vs. 86.3 ± 17.3, p = 0.017), sport (69.2 ± 26.4 vs. 82.1 ± 25.3, p = 0.017) and quality of life (61.2 ± 25.3 vs. 75.3 ± 26.2, p = 0.03). Only 29.2% of patients in the LMRT group achieved a patient acceptable symptom state (PASS), compared to 65.2% in the isolated ACLR group (p < 0.01).

Conclusion

Combined ACLR and LMRT repair resulted in a 7.1% failure rate. However, the addition of LMRT repair results in lower subjective outcomes compared to isolated ACLR. The use of an independent tibial tunnel for LMRT repair does not confer additional clinical benefit over the shared ACL tunnel technique.