全内侧修复完全性外侧半月板斜行放射状撕裂联合前交叉韧带重建术后的良好疗效：一项病例系列研究
简介
本研究纳入16例接受前交叉韧带重建（ACLR）同时行全内修复的完全性外侧半月板后角斜行放射状撕裂（距后根>1 cm，4型）患者，中位随访37.3个月。结果显示：患者报告结局指标显著改善，PROMIS疼痛干扰评分从60.3降至43.0，PROMIS活动能力评分从38.5升至61.1，IKDC评分从42.0升至91.4，SANE评分从25.0升至89.0（均P<…
英文摘要
OBJECTIVES: To evaluate the outcomes of repairing lateral meniscus oblique radial tears of the posterior horn (LMORT) that are complete and originate >1 cm from the posterior root (type 4), during anterior cruciate ligament reconstruction (ACLR) at a minimum of 2 years of follow-up. METHODS: In this case series (March 2018-March 2023), we included adults undergoing primary ACLR with type 4 LMORT all-inside repair and complete ≥2-year postoperative complication data. We assessed change from baseline and minimal clinically important difference (MCID) rate for the Patient Reported Outcome Measures Information System Pain Interference (PROMIS-PI) and Mobility (PROMIS-MO), International Knee Documentation Committee Subjective Knee Form (IKDC), Activity Rating Scale (ARS) and Single Assessment Numeric Evaluation (SANE). Return-to-sport (RTS), same-level RTS and complication (retear of lateral meniscus, reoperation, ACLR graft failure, infection, contralateral knee surgery) rates were reported. When available, we evaluated second-look arthroscopy and postoperative magnetic resonance imaging (MRI) findings. RESULTS: In 16 cases (median follow-up; 37.3 [29.1-65.3] months), improvement was noted in median PROMIS-PI (60.3 [57.7-65.8] vs 43.0 [39.0-48.9]; p < 0.001), PROMIS-MO (38.5 [33.5-40.8] vs 61.1 [54.0-66.8]; p < 0.001), IKDC (42.0 [23.5-48.0] vs 91.4 [82.8-96.6]; p < 0.001) and SANE (25.0 [10.0-38.3] vs 89.0 [80.0-95.0]; p = 0.002). No statistically significant differences were observed for ARS (16.0 [13.0-16.0] vs 12.0 [8.0-14.5] p = 0.099). MCID rates were 85.7 %, 92.9 %, 100 %, 57.1 % and 78.6 % for PROMIS-PI, PROMIS-MO, IKDC, ARS and SANE, respectively. RTS and same-level RTS rates were 12/14 (85.7 %) and 8/14 (57.1 %), respectively. Three (18.8 %) patients underwent ipsilateral knee reoperations; none for lateral meniscus retears. There was one (6.3 %) contralateral knee operation. Complete LMORT repair healing was observed on available second-look arthroscopies and MRIs. CONCLUSIONS: Our study of patients with type 4 LMORT repair during ACLR supports the limited existing evidence by demonstrating statistically significant improvement in patient-reported outcome measures, low complication rates and satisfactory healing patterns. Our findings should further encourage all-inside repair of type 4 LMORTs during ACLR, as it results in high RTS and substantial same-level RTS. LEVEL OF EVIDENCE: IV. Case-series.