Clinical and Radiographic Outcomes of Arthroscopic Medial Meniscus Posterior Root Repair Using Soft Suture Anchor without Posterior Portal Technique.

IF 1.9 2区 医学 Q2 ORTHOPEDICS Clinics in Orthopedic Surgery Pub Date : 2024-12-01 Epub Date: 2024-11-15 DOI:10.4055/cios24099
Napatpong Thamrongskulsiri, Pongsatorn Pholkerd, Danaithep Limskul, Thanathep Tanpowpong, Somsak Kuptniratsaikul, Thun Itthipanichpong
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Abstract

Background: The medial meniscus posterior root tear is a common cause of knee osteoarthritis, often misdiagnosed. Surgical repair aims to restore knee biomechanics, with evolving techniques focusing on direct fixation. The objective of this study was to evaluate the clinical and radiographic outcomes of arthroscopic soft suture anchor repair, without utilizing the posterior portal technique, for medial meniscus posterior root tears over a 2-year follow-up period.

Methods: This is a retrospective study involving 32 patients, including 13 men and 19 women, with a mean age of 57 years and follow-up of 2 years. All tears were classified as LaPrade type 2 medial meniscus posterior root tears. The paired t-test was used to compare the International Knee Documentation Committee Subjective Knee Form (IKDC) and Lysholm score, as well as meniscus extrusion between preoperative and postoperative states. The Wilcoxon signed-rank test was utilized to compare the Kellgren-Lawrence (KL) grades. Healing rates were assessed on magnetic resonance imaging (MRI).

Results: MRI revealed complete healing in 17 out of 32 knees (53.1%), partial healing in 12 knees (37.5%), and signs of retear in 3 knees (9.4%). At final follow-up, the mean IKDC and Lysholm scores were 57.4 ± 10.3 and 84.8 ± 11.3, respectively, showing significant improvement from preoperative values (c 0.001). There was also a significant reduction in medial meniscus extrusion postoperatively, decreasing from 4.1 ± 0.8 mm preoperatively to 3.6 ± 0.9 mm postoperatively (p = 0.002). Additionally, KL grades did not progress significantly during the 2-year follow-up period, as evidenced by median KL grades of 2 both preoperatively and postoperatively (p = 0.072).

Conclusions: Arthroscopic repair of medial meniscus posterior root tears using a soft suture anchor without a posterior portal yielded a high healing rate in MRI and favorable patient-reported outcomes in short-term follow-up duration.

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关节镜下无后门静脉技术软缝线锚钉修复内侧半月板后根的临床和影像学结果。
背景:内侧半月板后根撕裂是膝关节骨性关节炎的常见原因,常被误诊。手术修复的目的是恢复膝关节的生物力学,随着技术的发展,重点是直接固定。本研究的目的是评估关节镜下软缝合锚钉修复术的临床和影像学结果,不使用后门静脉技术,治疗内侧半月板后根撕裂,随访2年。方法:回顾性研究32例患者,其中男性13例,女性19例,平均年龄57岁,随访2年。所有撕裂均归类为LaPrade 2型内侧半月板后根撕裂。配对t检验用于比较国际膝关节文献委员会主观膝关节形态(IKDC)和Lysholm评分,以及术前和术后状态之间的半月板挤压。采用Wilcoxon符号秩检验比较Kellgren-Lawrence (KL)等级。通过磁共振成像(MRI)评估愈合率。结果:MRI显示32个膝关节中17个完全愈合(53.1%),12个部分愈合(37.5%),3个膝关节有复发迹象(9.4%)。在最后随访时,平均IKDC和Lysholm评分分别为57.4±10.3和84.8±11.3,较术前有显著改善(c 0.001)。术后内侧半月板挤压也明显减少,从术前4.1±0.8 mm减少到术后3.6±0.9 mm (p = 0.002)。此外,在2年随访期间,KL评分没有显著提高,术前和术后中位KL评分均为2分(p = 0.072)。结论:关节镜下使用无后门静脉的软缝线锚钉修复内侧半月板后根撕裂,MRI显示愈合率高,患者报告的短期随访结果良好。
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来源期刊
CiteScore
3.50
自引率
4.00%
发文量
85
审稿时长
36 weeks
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