与两期手术相比，单期前交叉韧带重建和移位桶柄半月板修复术的半月板修复失败率较低

IF 2.7 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2025-03-07 DOI:10.1002/jeo2.70199

Carolina Kekki, Riccardo Cristiani, Anders Stålman, Christoffer von Essen

{"title":"与两期手术相比，单期前交叉韧带重建和移位桶柄半月板修复术的半月板修复失败率较低","authors":"Carolina Kekki, Riccardo Cristiani, Anders Stålman, Christoffer von Essen","doi":"10.1002/jeo2.70199","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>To compare displaced bucket-handle meniscus repair (BHMR) failure rates, subjective and objective knee function after BHMR in the setting of ACLR performed as a single-or two-stage procedure, and assess factors associated with BHMR survival.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective study included patients who underwent surgery between February 2015 and December 2021 at one institution. Patients with a displaced bucket-handle meniscus tear (BHMT) and ACL-injury undergoing BHMR and ACLR as a single- (concomitant BHMR and ACLR) or two-stage (BHMR and subsequent ACLR) procedure were identified. The primary outcome was the 2-year BHMR failure rate following ACLR, defined as reoperation with meniscus re-repair or resection. Additionally, 6-month range of motion (ROM), isokinetic knee (extension, flexion) strength, 1-and 2-year Knee injury and Osteoarthritis Outcome Score (KOOS), Patient-acceptable symptom state (PASS), treatment failure (TF) were compared between the groups. Kaplan-Meier analysis was performed to assess BHMR survival, factors associated with repair survival were analysed through Cox proportional hazard regression analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The cohort included 159 displaced BHMRs, 120 (75.5%) underwent single-stage surgery. The overall BHMR failure rate was 27% (43/159). The single-stage surgery group had significantly lower failure rate (15% vs. 35.9%, <i>p</i> = 0.006). BHMT laterality, subjective (KOOS, PASS and TF) and objective (ROM, isokinetic strength) knee function did not differ significantly between the groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Patients who underwent single-stage displaced BHMR and ACLR had significantly lower BHMR failure rate compared to those who underwent two-stage surgery. Therefore, single-stage displaced BHMR and ACLR should be advocated, although patient-specific factors and further prospective studies remain important considerations.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III.</p>\n </section>\n </div>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70199","citationCount":"0","resultStr":"{\"title\":\"Single-stage ACL reconstruction and displaced bucket handle Meniscus repair is associated with lower Meniscus repair failure rates compared to two-stage surgery\",\"authors\":\"Carolina Kekki, Riccardo Cristiani, Anders Stålman, Christoffer von Essen\",\"doi\":\"10.1002/jeo2.70199\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>To compare displaced bucket-handle meniscus repair (BHMR) failure rates, subjective and objective knee function after BHMR in the setting of ACLR performed as a single-or two-stage procedure, and assess factors associated with BHMR survival.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective study included patients who underwent surgery between February 2015 and December 2021 at one institution. Patients with a displaced bucket-handle meniscus tear (BHMT) and ACL-injury undergoing BHMR and ACLR as a single- (concomitant BHMR and ACLR) or two-stage (BHMR and subsequent ACLR) procedure were identified. The primary outcome was the 2-year BHMR failure rate following ACLR, defined as reoperation with meniscus re-repair or resection. Additionally, 6-month range of motion (ROM), isokinetic knee (extension, flexion) strength, 1-and 2-year Knee injury and Osteoarthritis Outcome Score (KOOS), Patient-acceptable symptom state (PASS), treatment failure (TF) were compared between the groups. Kaplan-Meier analysis was performed to assess BHMR survival, factors associated with repair survival were analysed through Cox proportional hazard regression analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The cohort included 159 displaced BHMRs, 120 (75.5%) underwent single-stage surgery. The overall BHMR failure rate was 27% (43/159). The single-stage surgery group had significantly lower failure rate (15% vs. 35.9%, <i>p</i> = 0.006). BHMT laterality, subjective (KOOS, PASS and TF) and objective (ROM, isokinetic strength) knee function did not differ significantly between the groups.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Patients who underwent single-stage displaced BHMR and ACLR had significantly lower BHMR failure rate compared to those who underwent two-stage surgery. Therefore, single-stage displaced BHMR and ACLR should be advocated, although patient-specific factors and further prospective studies remain important considerations.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>Level III.</p>\\n </section>\\n </div>\",\"PeriodicalId\":36909,\"journal\":{\"name\":\"Journal of Experimental Orthopaedics\",\"volume\":\"12 1\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-03-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jeo2.70199\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Experimental Orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70199\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Experimental Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/jeo2.70199","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

摘要

目的比较单期或双期ACLR中移位桶柄半月板修复（BHMR）的失败率、主观和客观膝关节功能，并评估与BHMR生存相关的因素。方法本回顾性研究纳入2015年2月至2021年12月在一家机构接受手术的患者。对移位的桶柄半月板撕裂（BHMT）和acl损伤患者进行BHMR和ACLR单期（合并BHMR和ACLR）或两期（BHMR和随后的ACLR）手术。主要结果是ACLR后2年BHMR失败率，定义为半月板再手术或半月板再修复或切除。此外，比较两组患者6个月活动度（ROM）、膝关节等速（伸展、屈曲）强度、1年和2年膝关节损伤和骨关节炎结局评分（oos）、患者可接受症状状态（PASS）、治疗失败（TF）。采用Kaplan-Meier分析评估BHMR生存，通过Cox比例风险回归分析分析与修复生存相关的因素。结果纳入159例移位的BHMRs患者，其中120例（75.5%）行单期手术。总体BHMR失败率为27%（43/159）。单期手术组失败率明显低于手术组（15% vs. 35.9%, p = 0.006）。BHMT侧度、主观（oos、PASS和TF）和客观（ROM、等速力量）膝关节功能在组间无显著差异。结论单期移位BHMR和ACLR患者的BHMR失败率明显低于两期手术患者。因此，应该提倡单期移位BHMR和ACLR，尽管患者特异性因素和进一步的前瞻性研究仍然是重要的考虑因素。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。

摘要图片

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Single-stage ACL reconstruction and displaced bucket handle Meniscus repair is associated with lower Meniscus repair failure rates compared to two-stage surgery

Purpose

To compare displaced bucket-handle meniscus repair (BHMR) failure rates, subjective and objective knee function after BHMR in the setting of ACLR performed as a single-or two-stage procedure, and assess factors associated with BHMR survival.

Methods

This retrospective study included patients who underwent surgery between February 2015 and December 2021 at one institution. Patients with a displaced bucket-handle meniscus tear (BHMT) and ACL-injury undergoing BHMR and ACLR as a single- (concomitant BHMR and ACLR) or two-stage (BHMR and subsequent ACLR) procedure were identified. The primary outcome was the 2-year BHMR failure rate following ACLR, defined as reoperation with meniscus re-repair or resection. Additionally, 6-month range of motion (ROM), isokinetic knee (extension, flexion) strength, 1-and 2-year Knee injury and Osteoarthritis Outcome Score (KOOS), Patient-acceptable symptom state (PASS), treatment failure (TF) were compared between the groups. Kaplan-Meier analysis was performed to assess BHMR survival, factors associated with repair survival were analysed through Cox proportional hazard regression analysis.

Results

The cohort included 159 displaced BHMRs, 120 (75.5%) underwent single-stage surgery. The overall BHMR failure rate was 27% (43/159). The single-stage surgery group had significantly lower failure rate (15% vs. 35.9%, p = 0.006). BHMT laterality, subjective (KOOS, PASS and TF) and objective (ROM, isokinetic strength) knee function did not differ significantly between the groups.

Conclusion

Patients who underwent single-stage displaced BHMR and ACLR had significantly lower BHMR failure rate compared to those who underwent two-stage surgery. Therefore, single-stage displaced BHMR and ACLR should be advocated, although patient-specific factors and further prospective studies remain important considerations.