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Emphasizing the Importance of Naproxen Prophylaxis May Decrease the Rate of Heterotopic Ossification After Hip Arthroscopy 强调萘普生预防的重要性可降低髋关节镜检查后异位骨化的发生率
Q3 Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.asmr.2024.100941

Purpose

To investigate the incidence of heterotopic ossification (HO) in patients prescribed prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs), both before and after the introduction of a standardized education protocol.

Methods

A retrospective review was conducted using a database of hip arthroscopy patients treated by a single surgeon at an academic hospital from 2015 to 2023. The inclusion criteria were (1) primary hip arthroscopy for the treatment of femoroacetabular impingement, (2) completion of a 2-week course of prophylactic postoperative NSAIDs (500 mg of naproxen twice daily), and (3) availability of follow-up radiographs at the 6-month postoperative visit. The control cohort was merely prescribed the postoperative prophylactic NSAIDs, whereas the intervention cohort also received dedicated in-person education, emphasizing the importance of NSAID adherence. The presence of HO was determined through review of follow-up radiographs. Standard descriptive statistics were used to describe the findings.

Results

Both the control and intervention groups consisted of 200 continuous hip arthroscopy patients, with the control group treated from 2015 to 2017 and the intervention group treated from 2020 to 2023. Within the control group, 10 cases of HO (5%) were detected. Within the intervention group, 2 cases of HO (1%) were found. The Pearson χ2 test with Yates continuity correction produced a value of 4.21, with a P value of .04.

Conclusions

In this study, we found a significantly lower incidence rate of HO in patients who received standardized education on the importance of NSAID compliance versus those who did not. This finding suggests that patient education may play a contributory role in reducing the incidence of HO after hip arthroscopy.

Level of Evidence

Level III, comparative cohort study.

目的 研究在引入标准化教育方案前后,开具预防性非甾体类抗炎药(NSAIDs)的患者中异位骨化(HO)的发生率。方法 对一家学术医院的一名外科医生在 2015 年至 2023 年期间治疗的髋关节镜患者数据库进行回顾性审查。纳入标准为:(1)为治疗股骨髋臼撞击症而接受初次髋关节镜手术;(2)完成为期两周的术后非甾体抗炎药预防性治疗(500 毫克萘普生,每天两次);(3)术后 6 个月随访时提供随访 X 光片。对照组仅开具术后预防性非甾体抗炎药,而干预组还接受了专门的面对面教育,强调坚持服用非甾体抗炎药的重要性。通过复查随访X光片确定是否存在HO。结果对照组和干预组均由200名连续接受髋关节镜检查的患者组成,对照组的治疗时间为2015年至2017年,干预组的治疗时间为2020年至2023年。对照组发现10例HO(5%)。干预组发现 2 例 HO(1%)。结论在这项研究中,我们发现接受了关于非甾体抗炎药依从性重要性的标准化教育的患者与未接受此类教育的患者相比,HO 的发病率明显降低。这一发现表明,患者教育可能有助于降低髋关节镜手术后HO的发生率。
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引用次数: 0
Most Patients Older Than 40 Years of Age Who Underwent Meniscal Root Repair Presented With an Effusion, a Positive McMurray Test, and a Positive Hyperflexion Test 大多数接受半月板根部修复术的 40 岁以上患者都出现了渗出、麦克默里试验阳性和超屈试验阳性的情况
Q3 Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.asmr.2024.100949

Purpose

To analyze the presenting symptoms and clinical examination findings of patients undergoing meniscal root repairs to aid physicians in diagnosing this injury.

Methods

All patients undergoing isolated arthroscopic meniscal root repair from January 1, 2016, to September 1, 2021, were identified. Patients younger than the age of 40 years were excluded. Clinical notes were reviewed for presenting symptoms and physical examination findings. Preoperative radiographs were graded using the Kellgren-Lawrence (KL) scale for osteoarthritis. Root tears were graded using the radiographic criteria of Chung et al. and articular cartilage injury was graded using a validated system, AMADEUS (mean total Area Measurement And Depth & Underlying Structures).

Results

In total, 221 patients met inclusion criteria; 65.6% of patients reported that their pain began after an acute injury, with 39.4% of patients reporting a “pop.” On examination, an effusion was present in 71% of knees. McMurray test was reported positive in 85.5% and a positive hyperflexion test in 53.8% of knees. In total, 49.5% of knees were graded KL 1. 154 had medial root tears, 10 had lateral root tears, and 24 suffered both root tears. In total, 44.1% of tears occurred at the midsubstance of the root, with 28.0% occurring at the enthesis and 28.0% occurring at the root-posterior horn junction. The mean AMADEUS score was 94.4 ± 11.4.

Conclusions

Although most patients reported pain began after acute injury, less than one-half reported hearing a “pop.” When patients were evaluated, an effusion, positive McMurray test, and positive hyperflexion test were present in most meniscal root tears.

Level of Evidence

Level IV, diagnostic case series.

目的分析接受半月板根部修复术的患者的主要症状和临床检查结果,以帮助医生诊断这种损伤。方法确定2016年1月1日至2021年9月1日期间接受孤立关节镜半月板根部修复术的所有患者。排除年龄小于 40 岁的患者。回顾临床笔记,了解主要症状和体格检查结果。术前X光片采用凯尔格伦-劳伦斯(Kellgren-Lawrence,KL)骨关节炎量表进行分级。根部撕裂采用 Chung 等人的放射学标准进行分级,关节软骨损伤采用经过验证的系统 AMADEUS(平均总面积测量和深度示意图;基底结构)进行分级。结果共有 221 名患者符合纳入标准;65.6% 的患者称其疼痛始于急性损伤,39.4% 的患者称 "啪 "的一声。经检查,71%的膝关节存在积液。据报告,85.5%的膝关节麦克默里试验呈阳性,53.8%的膝关节过度屈曲试验呈阳性。总共有 49.5% 的膝关节被评为 KL 1 级。154 个膝关节内侧根撕裂,10 个膝关节外侧根撕裂,24 个膝关节双侧根撕裂。总计有44.1%的撕裂发生在根部中层,28.0%发生在内侧,28.0%发生在根部-后角交界处。AMADEUS评分的平均值为94.4±11.4。结论虽然大多数患者报告疼痛始于急性损伤后,但只有不到二分之一的患者报告听到 "啪 "的一声。在对患者进行评估时,大多数半月板根部撕裂都存在渗出、麦克默里试验阳性和过度屈曲试验阳性。
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引用次数: 0
Arthroscopy Patients in Medicare Population Became Sicker While Reimbursement Decreased From 2013 to 2020 从 2013 年到 2020 年,医疗保险人群中的关节镜手术患者越来越多,而报销额度却在下降
Q3 Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.asmr.2024.100950

Purpose

To assess surgeon reimbursement for common arthroscopic procedures, including arthroscopic meniscal debridement and arthroscopic rotator cuff repair, in patients with differing risk profiles within the Medicare population.

Methods

A publicly available Medicare database was used to identify all cases of arthroscopic meniscal debridement and arthroscopic rotator cuff repair procedures billed to Medicare from 2013 to 2020. The surgeon reimbursement from Medicare was collected and adjusted for inflation. All procedure episodes were split into 2 cohorts; those with a hierarchical condition category (HCC) risk score ≥1.5, and those with patient HCC risk scores <1.5. Reimbursement rates were compared between groups.

Results

From 2013 to 2020, a total of 624,077 meniscal debridement procedures and 567,794 arthroscopic rotator cuff repairs were billed to Medicare Part B. During this time, the mean adjusted surgeon reimbursement for arthroscopic rotator cuff repair decreased by 9.2% from 2013 to 2020. During the same time period, the adjusted mean surgeon reimbursement for arthroscopic both compartment meniscal debridement and single compartment meniscal debridement decreased by 7.9% and 9.9%, respectively. Throughout the study period, the mean HCC risk score increased from 1.19 in 2013 to 1.31 in 2020 (P < .001). Across all years in the study, the sicker cohort had a significantly greater rate of all comorbidities and a greater mean body mass index (P < .001 for all variables). The mean reimbursement across this cohort was lower for both rotator cuff repair (P = .037) and meniscal debridement procedures (P < .001) compared with the healthier cohort.

Conclusions

This study demonstrates that from 2013 to 2020, inflation-adjusted surgeon reimbursement for arthroscopic rotator cuff repair and meniscal debridement decreased while patient complexity increased. Further, mean surgeon reimbursement was lower among patients with more complexity in comparison with their healthier counterparts for such procedures.

Level of Evidence

Level III, retrospective cohort study.

目的 评估医疗保险人群中不同风险特征患者的常见关节镜手术(包括关节镜下半月板剥除术和关节镜下肩袖修复术)的外科医生报销情况。方法 使用公开的医疗保险数据库来识别 2013 年至 2020 年期间向医疗保险付费的所有关节镜下半月板剥除术和关节镜下肩袖修复术病例。我们收集了外科医生从医疗保险中报销的费用,并根据通货膨胀率进行了调整。所有手术事件被分为两组:分层条件类别(HCC)风险评分≥1.5的手术和患者HCC风险评分<1.5的手术。结果从 2013 年到 2020 年,共有 624,077 例半月板清创术和 567,794 例关节镜下肩袖修复术被纳入医疗保险 B 部分。在此期间,关节镜下肩袖修复术的调整后外科医生平均报销额从 2013 年到 2020 年下降了 9.2%。在同一时期,关节镜双腔半月板剥除术和单腔半月板剥除术的调整后外科医生平均报销额分别下降了 7.9% 和 9.9%。在整个研究期间,平均 HCC 风险评分从 2013 年的 1.19 上升到 2020 年的 1.31(P < .001)。在研究的所有年份中,病情较重的组群的所有合并症发生率明显更高,平均体重指数也更高(所有变量的 P < .001)。与健康人群相比,该人群的肩袖修复术(P = 0.037)和半月板剥离术(P <.001)的平均报销额度较低。结论本研究表明,从 2013 年到 2020 年,经通货膨胀调整后,关节镜肩袖修复术和半月板剥离术的外科医生报销额度有所下降,而患者的复杂性却有所增加。此外,复杂性更高的患者与更健康的患者相比,此类手术的外科医生平均报销额度更低。
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引用次数: 0
Meniscus-Related Videos on TikTok Are Widely Viewed and Shared but the Educational Quality for Patients Is Poor TikTok 上与半月板相关的视频被广泛观看和分享,但对患者的教育质量却很差
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100927
Riccardo D’Ambrosi M.D. , Timothy E. Hewett M.D.

Purpose

To evaluate the quality of meniscus-related TikTok videos to better understand their value for patient education.

Methods

The term “meniscus” was used as the key word for an extensive online search of video content on the TikTok on November 14, 2023. The first 100 videos were used for analysis. The duration of the videos and the number of likes, shares, and views were recorded for each video. Furthermore, videos were categorized based on the source (health workers, private user), the type of subject (patient experience, physical therapy, anatomy, clinical examination, surgical technique and injury mechanism), type of content (patient experience/testimony, education, rehabilitation), and the presence of music or voice. The quality and reliability assessments of video contents were conducted using the DISCERN instrument, the Journal of the American Medical Association benchmark criteria, and Global Quality Score.

Results

Of the 100 videos included in this study, 62 (62%) videos were published by health workers and 38 by private users (38%). Most of the information regarded patient experience (36, 36%), followed by physical therapy (32, 32%), anatomy (14, 14%), clinical examination (8, 8%), surgical technique (6, 6%), and injury mechanism (4, 4%). Video content reported patient experience in 39 (39%) videos, rehabilitation in 31 (31%) videos, and education in the remaining 30 (30%). The mean length of the videos was 39.12 ± 49.56 seconds. The mean number of views was 1,383,001.65 ± 5,291,822.28, whereas the mean numbers of comments, likes and shares were 408.53 ± 1976.90, 54,763.43 ± 211,823.44 and 873.70 ± 2,802.01, respectively. The mean DISCERN score, Journal of the American Medical Association benchmark criteria score, and Global Quality Score were 17.93 ± 5.07, 0.24 ± 0.47, and 1.15 ± 0.41, respectively.

Conclusions

Meniscus-related videos on TikTok are widely viewed and shared but the overall educational value to patients is poor.

Clinical Relevance

As patients increasingly use social media to learn about their conditions, it is important for orthopaedic health care professionals to understand the limitations of TikTok videos addressing the meniscus as potential sources of information for their patients.

目的评估与半月板相关的 TikTok 视频的质量,以更好地了解其对患者教育的价值。方法使用 "半月板 "作为关键词,对 2023 年 11 月 14 日 TikTok 上的视频内容进行广泛的在线搜索。前 100 个视频被用于分析。记录了每个视频的持续时间、点赞数、分享数和观看数。此外,视频还根据来源(医务工作者、私人用户)、主题类型(患者经历、物理治疗、解剖学、临床检查、手术技术和损伤机制)、内容类型(患者经历/证词、教育、康复)以及是否有音乐或语音进行了分类。研究使用 DISCERN 工具、《美国医学会杂志》基准标准和全球质量评分对视频内容的质量和可靠性进行了评估。大部分信息涉及患者体验(36,36%),其次是物理治疗(32,32%)、解剖学(14,14%)、临床检查(8,8%)、手术技术(6,6%)和损伤机制(4,4%)。视频内容方面,39 个视频(39%)报道了患者体验,31 个视频(31%)报道了康复,其余 30 个视频(30%)报道了教育。视频的平均长度为 39.12 ± 49.56 秒。平均观看次数为 1,383,001.65 ± 5,291,822.28 次,平均评论、点赞和分享次数分别为 408.53 ± 1976.90 次、54,763.43 ± 211,823.44 次和 873.70 ± 2,802.01 次。结论TikTok上与半月板相关的视频被广泛观看和分享,但对患者的整体教育价值较低。临床意义随着患者越来越多地使用社交媒体来了解自己的病情,骨科医护人员必须了解TikTok上与半月板相关的视频作为患者潜在信息来源的局限性。
{"title":"Meniscus-Related Videos on TikTok Are Widely Viewed and Shared but the Educational Quality for Patients Is Poor","authors":"Riccardo D’Ambrosi M.D. ,&nbsp;Timothy E. Hewett M.D.","doi":"10.1016/j.asmr.2024.100927","DOIUrl":"10.1016/j.asmr.2024.100927","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the quality of meniscus-related TikTok videos to better understand their value for patient education.</p></div><div><h3>Methods</h3><p>The term “meniscus” was used as the key word for an extensive online search of video content on the TikTok on November 14, 2023. The first 100 videos were used for analysis. The duration of the videos and the number of likes, shares, and views were recorded for each video. Furthermore, videos were categorized based on the source (health workers, private user), the type of subject (patient experience, physical therapy, anatomy, clinical examination, surgical technique and injury mechanism), type of content (patient experience/testimony, education, rehabilitation), and the presence of music or voice. The quality and reliability assessments of video contents were conducted using the DISCERN instrument, the <em>Journal of the American Medical Association</em> benchmark criteria, and Global Quality Score.</p></div><div><h3>Results</h3><p>Of the 100 videos included in this study, 62 (62%) videos were published by health workers and 38 by private users (38%). Most of the information regarded patient experience (36, 36%), followed by physical therapy (32, 32%), anatomy (14, 14%), clinical examination (8, 8%), surgical technique (6, 6%), and injury mechanism (4, 4%). Video content reported patient experience in 39 (39%) videos, rehabilitation in 31 (31%) videos, and education in the remaining 30 (30%). The mean length of the videos was 39.12 ± 49.56 seconds. The mean number of views was 1,383,001.65 ± 5,291,822.28, whereas the mean numbers of comments, likes and shares were 408.53 ± 1976.90, 54,763.43 ± 211,823.44 and 873.70 ± 2,802.01, respectively. The mean DISCERN score, <em>Journal of the American Medical Association</em> benchmark criteria score, and Global Quality Score were 17.93 ± 5.07, 0.24 ± 0.47, and 1.15 ± 0.41, respectively.</p></div><div><h3>Conclusions</h3><p>Meniscus-related videos on TikTok are widely viewed and shared but the overall educational value to patients is poor.</p></div><div><h3>Clinical Relevance</h3><p>As patients increasingly use social media to learn about their conditions, it is important for orthopaedic health care professionals to understand the limitations of TikTok videos addressing the meniscus as potential sources of information for their patients.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000452/pdfft?md5=16cd1ee774eed10bba785b5eab80f7a5&pid=1-s2.0-S2666061X24000452-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome 在股骨髋臼撞击综合征患者中,三维 CT 重建可比射线照相更灵敏地检测出钳状病变
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100918
Cory D. Smith M.D., Evan Simpson B.S., Bailey Johnson M.D., Edward Quilligan B.S., Robert Grumet M.D., Kevin C. Parvaresh M.D.

Purpose

To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Methods

We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed. Pincer lesions were defined as a lateral center-edge angle greater than 40°; a Tönnis angle greater than 0°; the presence of the ischial spine, crossover, or posterior wall sign; and the presence of overcoverage greater than 80%. Under “select criteria,” patients were classified as having a pincer lesion on XRs and 3D computed tomography reconstructions (CTRs) based on the lateral center-edge angle or Tönnis angle alone, whereas “all criteria” added the presence of the crossover sign and coverage percentage. Statistical analysis was performed to determine the diagnostic accuracy of XRs compared with 3D CTRs.

Results

A total of 69 patients met the inclusion criteria. There were 21 male patients (30.4%) and 48 female patients (69.6%). The mean age was 33 ± 13.5 years. χ2 Analysis for select criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ2 Analysis for all criteria found that 3D CTR was more likely than XRs to detect a pincer lesion. χ2 Analysis further showed that when using XRs, a pincer lesion was more likely to be detected under all criteria than under select criteria. Likewise, when using 3D CTR, a pincer lesion was more likely to be detected under all criteria than under select criteria.

Conclusions

In this study, we found that 3D CTR detected pincer lesions in patients undergoing hip arthroscopy for FAIS with significantly higher sensitivity than XRs alone.

Level of Evidence

Level III, retrospective cohort study.

目的 在接受髋关节镜手术治疗股骨髋臼撞击综合征(FAIS)的患者中,评估X光片(XR)与三维(3D)计算机断层扫描相比检测钳状病变的诊断能力。方法 我们对2020年9月1日至2022年10月2日期间接受髋关节镜手术治疗股骨髋臼撞击综合征的所有患者进行了回顾性审查。对术前影像学进行了回顾。钳状病变的定义是:外侧中心-边缘角度大于 40°;Tönnis 角度大于 0°;存在峡部棘征、交叉征或后壁征;存在大于 80% 的过度覆盖。在 "选择标准 "下,仅根据X光片和三维计算机断层扫描重建(CTR)的外侧中心边缘角或Tönnis角将患者归类为钳状病变,而 "所有标准 "则增加了交叉征和覆盖率的存在。结果 共有 69 名患者符合纳入标准。其中男性患者 21 人(30.4%),女性患者 48 人(69.6%)。选择标准的χ2分析发现,三维 CTR 比 XR 更有可能检测到钳状病变。χ2 对所有标准进行分析后发现,三维 CTR 比 XR 更有可能检测到钳状病变。χ2 分析进一步表明,使用 XRs 时,在所有标准下检测到钳状病变的可能性比在选择标准下检测到钳状病变的可能性大。结论在这项研究中,我们发现 3D CTR 在接受髋关节镜检查以治疗 FAIS 的患者中检测到钳状病变的灵敏度明显高于单独使用 XR。
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引用次数: 0
Previous Knee Surgery, Anteromedial Portal Drilling, Quadriceps Tendon Autograft, and Meniscal Involvement Associated With Delayed Return to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Athletes 业余运动员前交叉韧带重建术后延迟恢复运动与膝关节手术、前内侧门户钻孔、股四头肌腱自体移植和半月板受累有关
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100911
Mark A. Glover B.S. , Jeffery D. St. Jeor M.D. , Nihir Parikh B.S. , Danielle E. Rider M.D. , Garrett S. Bullock D.P.T., D.Phil. , Nicholas A. Trasolini M.D. , Brian R. Waterman M.D.

Purpose

To identify prognostic factors associated with a delayed return-to-sport (RTS) time in amateur athletes who return to full participation after a primary isolated anterior cruciate ligament (ACL) reconstruction.

Methods

A retrospective review was performed among athletes who underwent ACL reconstruction between October 2014 and October 2021. Inclusion criteria were any amateur athletes with an ACL reconstruction who had a documented RTS and greater than 1-year follow-up. Nonathletes, those with multiligamentous knee injury, and those missing documented RTS timelines were excluded. RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.

Results

In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, P < .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; P < .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, P < .001; 1.04, 95% CI 1.01-1.07, P = .020; 1.11, 95% CI 1.03-1.19, P = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, P < .001).

Conclusions

Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.

Level of Evidence

Level IV, prognostic case series.

目的 找出业余运动员在接受原发性孤立前交叉韧带(ACL)重建术后重返赛场(RTS)时间延迟的相关预后因素。方法 对 2014 年 10 月至 2021 年 10 月间接受前交叉韧带重建术的运动员进行回顾性研究。纳入标准是所有接受过前交叉韧带重建术的业余运动员,他们都有RTS记录,且随访时间超过1年。非运动员、膝关节多韧带损伤者和缺少有记录的 RTS 时间线者被排除在外。RTS的定义是参与运动的水平相当于或高于受伤前的参与水平。人口统计学和预后因素,包括既往膝关节手术、半月板受累情况、参与水平、手术方式和移植物类型,均与RTS时间一并记录,并通过泊松回归进行分析。结果在2014年至2021年期间,共有91名平均年龄为18.8(±6.7)岁的运动员在一家机构接受了前交叉韧带重建手术,平均随访时间为4.6(±2.5)年(范围为1.1-9.0)。半月板受累(1.11;95% 置信区间 [CI] 1.08-1.15,P <.001)和既往膝关节手术(1.43;95% CI 1.29-1.58;P <.001)与延迟 RTS 有关。与腘绳肌自体移植物相比,股四头肌腱和骨-髌腱-骨自体移植物以及同种异体移植物与较长的 RTS 时间有显著相关性(1.16,95% CI 1.13-1.20,P < .001;1.04,95% CI 1.01-1.07,P = .020;1.11,95% CI 1.03-1.19,P = .004)。19,95% CI 1.16-1.23,P <.001)。结论在能够重返赛场的年轻运动员中,先前的膝关节手术、股骨内侧前门钻孔、股四头肌腱自体移植和半月板撕裂与RTS的时间延迟最为相关。
{"title":"Previous Knee Surgery, Anteromedial Portal Drilling, Quadriceps Tendon Autograft, and Meniscal Involvement Associated With Delayed Return to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Athletes","authors":"Mark A. Glover B.S. ,&nbsp;Jeffery D. St. Jeor M.D. ,&nbsp;Nihir Parikh B.S. ,&nbsp;Danielle E. Rider M.D. ,&nbsp;Garrett S. Bullock D.P.T., D.Phil. ,&nbsp;Nicholas A. Trasolini M.D. ,&nbsp;Brian R. Waterman M.D.","doi":"10.1016/j.asmr.2024.100911","DOIUrl":"10.1016/j.asmr.2024.100911","url":null,"abstract":"<div><h3>Purpose</h3><p>To identify prognostic factors associated with a delayed return-to-sport (RTS) time in amateur athletes who return to full participation after a primary isolated anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>A retrospective review was performed among athletes who underwent ACL reconstruction between October 2014 and October 2021. Inclusion criteria were any amateur athletes with an ACL reconstruction who had a documented RTS and greater than 1-year follow-up. Nonathletes, those with multiligamentous knee injury, and those missing documented RTS timelines were excluded. RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.</p></div><div><h3>Results</h3><p>In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, <em>P</em> &lt; .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; <em>P</em> &lt; .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, <em>P</em> &lt; .001; 1.04, 95% CI 1.01-1.07, <em>P</em> = .020; 1.11, 95% CI 1.03-1.19, <em>P</em> = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, <em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.</p></div><div><h3>Level of Evidence</h3><p>Level IV, prognostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000294/pdfft?md5=e741866ffbc3e96342e1bba123f83a04&pid=1-s2.0-S2666061X24000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139965952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open Biceps Tenodesis and Tenotomy Have Low 30-Day Postoperative Complication Rates 开放式肱二头肌腱膜切除术和腱膜切开术的术后 30 天并发症发生率较低
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100928
Sarah Whitaker B.A. , Sarah Cole B.A. , Maria Peri B.S. , James Satalich M.D. , Conor O’Neill M.D. , Alexander Vap M.D.

Purpose

To compare 30-day postoperative rates of adverse events, particularly infection rates, between open biceps tenodesis and biceps tenotomy.

Methods

The American College of Surgeons National Surgical Quality Improvement Program was filtered using Current Procedural Terminology codes to identify patients undergoing open biceps tenodesis and tenotomy from 2010 to 2021. Patients were divided into cohorts based on procedure type. Propensity score matching was used to account for confounding variables. Statistical analyses were conducted to compare 30-day postoperative outcomes between cohorts, as well as to evaluate secondary risk factors for complications.

Results

Overall, 12,367 patients were included in the study with 11,417 undergoing open biceps tenodesis and 950 undergoing biceps tenotomy. After matching, 1,900 patients were included in the final analysis. The rate of outpatient procedures in the tenodesis cohort was significantly higher than in the tenotomy cohort. Rates of any adverse event (AAE), sepsis, pneumonia, reoperation, and extended length of stay (LOS) were significantly higher in the tenotomy cohort compared with the tenodesis cohort. There was no difference in infection rates or wound dehiscence between the 2 groups. After multivariable analysis, increasing age, longer operative time, and history of bleeding disorders were associated with significantly higher odds of developing AAE.

Conclusions

In this study, we found that tenotomy and open tenodesis are both safe options for treatment of biceps pathology. The overall rate of developing AAE and the rate of postoperative sepsis were higher in the tenotomy cohort. In addition, rates of postoperative infection and wound dehiscence did not vary between the 2 groups. Small differences were additionally observed in rates of pneumonia, return to the operating room, and extended LOS, and these rates were higher in the tenotomy cohort.

Level of Evidence

Level III, retrospective comparative study.

目的比较开放式肱二头肌腱膜切除术和肱二头肌腱膜切开术的术后 30 天不良事件发生率,尤其是感染率。方法使用当前手术术语代码对美国外科医生学会国家外科质量改进计划进行筛选,以确定 2010 年至 2021 年期间接受开放式肱二头肌腱膜切除术和腱膜切开术的患者。根据手术类型将患者分为不同组群。采用倾向评分匹配来考虑混杂变量。研究人员进行了统计分析,以比较不同组别患者的术后 30 天预后,并评估并发症的次要风险因素。结果研究共纳入了 12367 例患者,其中 11417 例接受了开放式肱二头肌腱膜切除术,950 例接受了肱二头肌腱膜切开术。经过配对后,有1900名患者被纳入最终分析。腱鞘切除术组的门诊手术率明显高于腱鞘切开术组。与腱膜切开术队列相比,腱膜切开术队列的任何不良事件(AAE)、败血症、肺炎、再次手术和延长住院时间(LOS)的发生率明显更高。两组患者的感染率和伤口开裂率没有差异。结论 在这项研究中,我们发现腱切开术和开放性腱鞘切除术都是治疗肱二头肌病变的安全选择。在腱切开术组中,发生 AAE 的总比率和术后败血症的比率较高。此外,两组患者的术后感染率和伤口开裂率没有差异。此外,在肺炎发生率、返回手术室率和延长住院时间方面也观察到了微小差异,而这些发生率在腱切开术组别中更高。
{"title":"Open Biceps Tenodesis and Tenotomy Have Low 30-Day Postoperative Complication Rates","authors":"Sarah Whitaker B.A. ,&nbsp;Sarah Cole B.A. ,&nbsp;Maria Peri B.S. ,&nbsp;James Satalich M.D. ,&nbsp;Conor O’Neill M.D. ,&nbsp;Alexander Vap M.D.","doi":"10.1016/j.asmr.2024.100928","DOIUrl":"10.1016/j.asmr.2024.100928","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare 30-day postoperative rates of adverse events, particularly infection rates, between open biceps tenodesis and biceps tenotomy.</p></div><div><h3>Methods</h3><p>The American College of Surgeons National Surgical Quality Improvement Program was filtered using <em>Current Procedural Terminology</em> codes to identify patients undergoing open biceps tenodesis and tenotomy from 2010 to 2021. Patients were divided into cohorts based on procedure type. Propensity score matching was used to account for confounding variables. Statistical analyses were conducted to compare 30-day postoperative outcomes between cohorts, as well as to evaluate secondary risk factors for complications.</p></div><div><h3>Results</h3><p>Overall, 12,367 patients were included in the study with 11,417 undergoing open biceps tenodesis and 950 undergoing biceps tenotomy. After matching, 1,900 patients were included in the final analysis. The rate of outpatient procedures in the tenodesis cohort was significantly higher than in the tenotomy cohort. Rates of any adverse event (AAE), sepsis, pneumonia, reoperation, and extended length of stay (LOS) were significantly higher in the tenotomy cohort compared with the tenodesis cohort. There was no difference in infection rates or wound dehiscence between the 2 groups. After multivariable analysis, increasing age, longer operative time, and history of bleeding disorders were associated with significantly higher odds of developing AAE.</p></div><div><h3>Conclusions</h3><p>In this study, we found that tenotomy and open tenodesis are both safe options for treatment of biceps pathology. The overall rate of developing AAE and the rate of postoperative sepsis were higher in the tenotomy cohort. In addition, rates of postoperative infection and wound dehiscence did not vary between the 2 groups. Small differences were additionally observed in rates of pneumonia, return to the operating room, and extended LOS, and these rates were higher in the tenotomy cohort.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective comparative study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000464/pdfft?md5=0b156ecaeb705f575831e7d62f978f80&pid=1-s2.0-S2666061X24000464-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eighty-One Percent of Unrepaired Interportal Capsulotomies Showed Healed Capsules on Magnetic Resonance Imaging 5 Years After Primary Hip Arthroscopy 原发性髋关节镜检查后 5 年,磁共振成像显示 81% 未修复的关节囊间切开术已痊愈
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100943
Onur Hapa M.D. , Selahaddin Aydemir M.D , Asli Irmak Akdogan M.D , Mustafa Celtik M.D , Ozgur Aydin M.D , Batuhan Gocer M.D , Onur Gursan M.D

Purpose

To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans.

Methods

Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score–Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans.

Results

Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group (P = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups (P > .05).

Conclusions

In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy.

Clinical Relevance

Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.

目的 评估初次髋关节镜手术后5年,未修复的关节囊间切开术是否会在磁共振成像(MRI)上显示关节囊缺损,并确定其对功能结果以及X光片或MRI扫描发现的骨关节炎的影响。方法 回顾性分析股骨髋臼撞击症患者(无关节炎或发育不良)在关节镜下通过未闭合的关节囊间切开术进行唇修补术或清创术和股骨成形术后的情况。使用患者报告的结果(髋关节结果评分-日常生活活动量表、改良哈里斯髋关节评分和视觉模拟评分表疼痛评分)、放射学测量和核磁共振扫描对患者进行术前和术后至少5年的评估。其中,81%的患者髋关节囊已愈合,8 例(19%)患者在最近一次核磁共振扫描中发现髋关节囊缺损。在最新的磁共振成像扫描中,囊缺损组有 3 个髋关节出现软骨下水肿,而囊愈合组仅有 1 个(P = 0.01),术前磁共振成像中并没有出现软骨下水肿(如果将术前α角也考虑在内,多变量分析结果仍为阳性)。结论在这项研究中,81% 的关节间囊切口在初次髋关节镜手术后 5 年愈合,未进行修补。临床意义了解未愈合关节间囊切口的发生率和影响可以鼓励外科医生在闭合关节囊时一丝不苟。
{"title":"Eighty-One Percent of Unrepaired Interportal Capsulotomies Showed Healed Capsules on Magnetic Resonance Imaging 5 Years After Primary Hip Arthroscopy","authors":"Onur Hapa M.D. ,&nbsp;Selahaddin Aydemir M.D ,&nbsp;Asli Irmak Akdogan M.D ,&nbsp;Mustafa Celtik M.D ,&nbsp;Ozgur Aydin M.D ,&nbsp;Batuhan Gocer M.D ,&nbsp;Onur Gursan M.D","doi":"10.1016/j.asmr.2024.100943","DOIUrl":"10.1016/j.asmr.2024.100943","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans.</p></div><div><h3>Methods</h3><p>Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score–Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans.</p></div><div><h3>Results</h3><p>Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group (<em>P</em> = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups (<em>P</em> &gt; .05).</p></div><div><h3>Conclusions</h3><p>In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy.</p></div><div><h3>Clinical Relevance</h3><p>Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000610/pdfft?md5=3768006f6948a9a0d2b81bd149da89d9&pid=1-s2.0-S2666061X24000610-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140787306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Blood Flow in the Meniscus Can Be Visualized Arthroscopically Using an Intravenous Indocyanine Green Solution Diluted 10× in a Pig Model 在猪模型中使用稀释 10 倍的静脉注射吲哚菁绿溶液可在关节镜下观察半月板的血流情况
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100932
Tamiko Kamimura M.D., Ph.D.

Purpose

To determine the optimal indocyanine green (ICG) dose required for assessing vascularity in the meniscus using ICG fluorescence-guided knee arthroscopy in a pig model.

Methods

A 3-month-old Japanese esculent female pig was used in this study. Intravenous injections of ICG (25 mg) were administered with 2.0 mL of 5×, 10×, 100×, and 1,000× diluted solutions. An additional experiment was conducted to assess the microvasculature within the meniscus considering the results of the optimal dilution setting. A radial tear was purposely induced in the middle-to-posterior section of the medial meniscus to observe vascularity in the cross-sectioned meniscus; the optimal ICG dilution was administered.

Results

No fluorescence was detected in the meniscus with solutions diluted by 1,000× and 100×. Fluorescence was visualized at the anterior portion of the synovium and the anterior cruciate ligament using ICG diluted by 10×. Diluting ICG by 5×, contrast enhancement was too intense for observation. Therefore, the 10× diluted solution was considered the optimal setting for knee arthroscopy and observation of the radial tear. No fluorescence was observed in the cross section of the medial meniscus. Arterial hemorrhage was observed by stimulating the fluorescence-dyed synovium adjacent to the tear site. Through the additional waiting time after stimulating the tear site, the hemorrhage inside the meniscus became more intense.

Conclusions

The optimal dilution and dose setting of ICG for knee arthroscopy was 10× in a 2.0-mL intravenous injection. The meniscus showed no active blood flow, even in the red-red zone. This finding might support the notion that blood flow cannot be initiated, without synovial stimulation, even in vascular areas.

Clinical Relevance

This study could determine an ICG solution suitable for ICG fluorescence-guided knee arthroscopy. This finding could be valuable in future research focusing on case-specific meniscal vascularization under arthroscopy, particularly applying these findings to human meniscal treatment.

目的 确定在猪模型中使用 ICG 荧光引导膝关节镜评估半月板血管所需的最佳吲哚菁绿(ICG)剂量。用 2.0 mL 5×、10×、100× 和 1,000× 稀释溶液静脉注射 ICG(25 mg)。考虑到最佳稀释设置的结果,还进行了另一项实验来评估半月板内的微血管。特意在内侧半月板的中后部诱发径向撕裂,以观察半月板横截面上的血管情况;使用最佳 ICG 稀释液。用 10 倍稀释的 ICG 在滑膜前部和前十字韧带可观察到荧光。将 ICG 稀释 5 倍后,对比度增强过于强烈,无法进行观察。因此,10 倍稀释溶液被认为是膝关节镜检查和观察桡侧撕裂的最佳设置。内侧半月板横截面未观察到荧光。通过刺激撕裂部位附近的荧光染色滑膜可观察到动脉出血。结论 膝关节镜检查中 ICG 的最佳稀释和剂量设置为 10 倍,静脉注射量为 2.0 毫升。即使在红-红区,半月板也没有活跃的血流。这项研究可以确定一种适合 ICG 荧光引导膝关节镜检查的 ICG 溶液。这一发现对未来研究关节镜下特定病例的半月板血管化很有价值,尤其是将这些发现应用于人体半月板治疗。
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引用次数: 0
Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone Autograft With Lateral Compartment Meniscectomy or Chondroplasty Does Not Lead to Decreased Return to Sport and Activity Compared With No Lateral Pathology 使用骨-髌腱-骨自体移植物进行前交叉韧带重建,同时进行外侧韧带半月板切除术或软骨成形术,与无外侧病变相比,不会导致运动和活动恢复能力下降
Q3 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.asmr.2024.100910
Sean Hazzard P.A., M.B.A., Saoirse Connolly B.S., Brendan Fitzgerald B.S., Peter Asnis M.D.

Purpose

To investigate the influence of lateral meniscal and cartilage pathology on the outcome after anterior cruciate ligament (ACL) reconstruction in patients who participate in pivoting sports.

Methods

Using a single-surgeon patient registry, patients undergoing an anterior cruciate ligament reconstruction (ACLR) using bone–patellar tendon–bone autograft were evaluated with minimum 2-year patient reported outcomes evaluated using Marx, Tegner, Lysholm, and International Knee Documentation Committee scales. Patients were divided into 3 groups: isolated ACL surgery, ACLR with a partial lateral meniscectomy, or a ACLR with partial lateral meniscectomy and lateral compartment chondroplasty.

Results

A total of 98 patients met inclusion criteria. Using the isolated ACL reconstruction group as a control, we found that Marx scores were greater in patients who additionally underwent a partial lateral meniscectomy at 1 year (P = .016). There were no significant differences between the ACL-only group and the ACL with partial lateral meniscectomy and chondroplasty group. Within the partial meniscectomy cohort comparing the patients with red-white zone tears with the patients with white-white zone tear, we found there were no significant differences when compared with the ACL-only control. There were no significant differences appreciated between groups using the International Knee Documentation Committee, Lysholm, and Tegner scales.

Conclusions

ACL reconstruction using bone–patellar tendon–bone autograft with anteromedial portal drilling technique does not have any significant short-term (2-year outcome) differences in return to activity and patient-reported outcomes compared with if patients additionally have a partial lateral meniscectomy and/or lateral compartment chondroplasty. Additional partial lateral meniscectomy showed significantly greater Marx scores at 1 and 2 years’ postoperatively.

Level of Evidence

Level III, retrospective cohort study.

目的 探讨外侧半月板和软骨病变对参与枢轴运动的患者前交叉韧带(ACL)重建术后疗效的影响。方法 使用单个外科医生的患者登记册,对使用骨-髌腱-骨自体移植进行前交叉韧带重建术(ACLR)的患者进行评估,并使用Marx、Tegner、Lysholm和国际膝关节文献委员会的量表评估患者报告的至少2年疗效。患者被分为三组:孤立的前交叉韧带手术组、前交叉韧带重建加外侧半月板部分切除术组、前交叉韧带重建加外侧半月板部分切除术加外侧软骨成形术组。以孤立的前交叉韧带重建组为对照,我们发现,1年后接受部分外侧半月板切除术的患者马克思评分更高(P = .016)。单纯前交叉韧带组与前交叉韧带加部分外侧半月板切除术和软骨成形术组之间没有明显差异。在半月板部分切除术组中,我们将红白区撕裂患者与白白区撕裂患者进行了比较,发现与单纯前交叉韧带对照组相比没有明显差异。使用国际膝关节文献委员会(International Knee Documentation Committee)、Lysholm 和 Tegner 量表评估各组间的差异也不明显。结论使用骨-髌腱-骨自体移植物和前内侧门户钻孔技术进行前交叉韧带重建与同时进行部分外侧半月板切除术和/或外侧室软骨成形术的患者相比,在恢复活动能力和患者报告结果方面没有任何明显的短期(2 年结果)差异。额外的部分外侧半月板切除术在术后1年和2年显示出明显更高的马克思评分。
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引用次数: 0
期刊
Arthroscopy Sports Medicine and Rehabilitation
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