Meniscal Root Tears—The Crippling Epidemic. Case Report and Literature Review

D. Crisan, D. Vermeşan, R. Prejbeanu, B. Deleanu, Sorin Craioveanu
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Abstract

(1) Background: Meniscal lesions are one of the most prevalent pathologies in orthopedics; meniscal root tears have been recognized as a specific subset with poor mid- to long-term results after standard treatment options (observation, physical therapy, arthroscopic partial meniscectomy) and frequent progression to osteoarthritis. Meniscal root repair has emerged as a new technique with promising results. We present a case report and review the current literature regarding the diagnosis, indications to repair, current techniques, alternatives and expected outcomes. (2) Case report: A 49-year-old woman, with a body mass index of 30 and no significant comorbidities or history of trauma, involved in moderate to heavy physical activity, presented with left knee pain at the internal meniscal line, which worsened over the last 4 months, despite an intra-articular steroid shot. Based on the magnetic resonance imaging (MRI), she was diagnosed with a type 2 medial meniscus posterior root tear and moderate internal compartment chondropathy (Outerbridge 2). She underwent side-to-side repair of the meniscal lesion and reattachment of the root through a bone tunnel over a button. Postoperatively, she was non-weight-bearing (NWB) for 6 weeks and with the knee immobilized at 30° of flexion. At 6 months’ follow-up, the patient was fully ambulant without crutches, with active knee flexion between 0° and 130°. (3) Conclusion: Meniscal root repair is reasonably accessible. It may provide additional benefits over current treatment options when used judiciously and with an adequate surgical technique.
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半月板根部撕裂——致残流行病病例报告及文献复习
(1)背景:半月板病变是骨科最常见的病变之一;半月板根撕裂被认为是标准治疗方案(观察、物理治疗、关节镜下半月板部分切除术)后中长期效果较差且经常进展为骨关节炎的一个特定子集。半月板牙根修复是一项具有良好效果的新技术。我们提出了一份病例报告,并回顾了目前关于诊断、修复指征、当前技术、替代方案和预期结果的文献。(2)病例报告:一名49岁女性,体重指数为30,无明显合并症或创伤史,参与中度至重度体育活动,表现为左膝半月板内线疼痛,尽管关节内注射类固醇,但在过去4个月内病情恶化。根据磁共振成像(MRI),她被诊断为2型内侧半月板后根撕裂和中度内腔室软骨病(Outerbridge 2)。她接受了半月板病变的侧对侧修复,并通过骨隧道在一个按钮上重新附着半月板根。术后患者无负重(NWB) 6周,膝关节屈曲30°固定。随访6个月时,患者无需拐杖即可完全行走,膝关节活动度在0°至130°之间。(3)结论:半月板牙根修复是可行的。如果使用得当并配合适当的手术技术,它可能比目前的治疗方案提供更多的好处。
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审稿时长
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