桶柄状及内侧半月板撕裂在接受全内修复联合前交叉韧带重建术后失败率更高
简介
该研究回顾性分析了1355例ACL重建同期行全内半月板缝合的患者，3年失败率（需再次手术）为12.3%。关键发现：内侧半月板修复失败率（17.7%）显著高于外侧（5.3%）；桶柄状撕裂失败率最高（18.6%），其次为下表面撕裂（15.6%）和纵行撕裂（11.2%），根部撕裂（6.1%）和放射状撕裂（5.6%）最低。多因素分析显示，内侧修复是失败的最强预测因素…
英文摘要
PURPOSE: To evaluate failure rates across specific meniscal tear morphologies in patients undergoing all-inside meniscal repair with anterior cruciate ligament reconstruction (ACLR), and to identify factors associated with failure. METHODS: This retrospective cohort included 1355 patients who underwent all-inside meniscal repair during ACLR between 2015 and 2022 at Capio Artro Clinic, Stockholm, Sweden. Failure was defined as reoperation within 3 years. Tear morphology, meniscal laterality, age and sex were recorded. Kaplan-Meier (KM) analysis assessed survival, and Cox regression identified factors associated with failure. RESULTS: The 3-year failure rate was 12.3%. Medial repairs failed significantly more than lateral repairs (17.7% vs. 5.3%; p < 0.001) with lower medial survival on KM analysis (log rank p < 0.001). Bucket handle tears had the highest failure rate (18.6%), followed by undersurface (15.6%) and longitudinal tears (11.2%). Root (6.1%) and radial tears (RTs) (5.6%) had the lowest. In multivariable analysis, medial repair was the strongest predictor of failure (hazard ratio [HR] 3.08, 95% confidence interval [CI] 2.03-4.67, p < 0.001). Longitudinal tears had lower failure risk than bucket handle tears (HR 0.67, 95% CI 0.57-0.95, p = 0.03). Female sex increased failure risk (HR 1.38, 95% CI 1.02-1.88, p = 0.03), while age >30 years was not associated with failure. CONCLUSION: Meniscal repair performed during ACL reconstruction demonstrated a 12.3% failure rate at 3 years. Failure risk differed by tear morphology and meniscal side, with medial repairs and bucket‑handle tears showing the highest risk, while root and RTs showed the lowest. Female sex was independently associated with increased failure, whereas age was not. LEVEL OF EVIDENCE: Level III, retrospective cohort study.