半月板根部修复联合中央化术
简介
本研究介绍了一种半月板根部修复联合中央化手术技术。研究通过关节镜下经胫骨隧道修复根部撕裂，并采用无结锚钉在胫骨平台内侧冠状位中点进行中央化固定，以纠正半月板外突。关键发现：该技术能有效恢复环箍应力、减少半月板外突，相比半月板切除术或保守治疗，患者疼痛、功能和活动水平改善更优，可延缓骨关节炎进展。临床意义：对于急性创伤性或慢性症状性根部撕裂且无严重关节炎的患者…
英文摘要
BACKGROUND: Meniscal root tears compromise hoop stress resistance and lead to elevated tibiofemoral contact pressures, meniscal extrusion, and rapid progression of osteoarthritis. Prompt diagnosis and intervention are essential to prevent further degenerative changes. INDICATIONS: Meniscal root repair is indicated in patients with acute traumatic tears or chronic symptomatic root tears without advanced arthritis. Root repair has been shown to be beneficial regardless of the patient's age, even in the setting of early arthritis. Contraindications to root repair are severe osteoarthritis or poor surgical candidacy. Meniscus centralization is an important augment to the repair, particularly in the setting of meniscal extrusion. TECHNIQUE DESCRIPTION: After diagnostic arthroscopy, visualization of the medial compartment is enhanced via controlled medial collateral ligament pie-crusting. The meniscal root footprint is decorticated, and the meniscotibial ligaments are released to mobilize the meniscus. Two luggage-tag sutures are placed across the tear and shuttled through a transtibial tunnel drilled to the native root footprint. A knotless anchor secures the repair. Centralization is achieved by placing a knotless all-suture anchor at the mid-coronal medial tibial plateau, with sutures passed in a mattress configuration through the meniscocapsular junction, preventing extrusion. Root sutures are then tensioned and fixed with the knee in 90° of flexion. RESULTS: This anatomic transtibial repair with centralization has been shown to restore hoop stresses, reduce meniscal extrusion, and provide superior outcomes compared with meniscectomy or nonoperative management. Patients undergoing root repair report improved pain, function, and activity levels. DISCUSSION/CONCLUSION: Transtibial meniscal root repair with centralization is a reproducible technique that restores meniscal function, minimizes extrusion, and delays the progression of osteoarthritis. The luggage-tag suture configuration mitigates suture cutout, and careful attention to centralization placement and tensioning optimizes outcomes. Postoperative rehabilitation should emphasize progressive weightbearing and strengthening, with return to sport typically achievable by 6 months. This approach provides durable symptom relief and joint preservation when applied to appropriately selected patients. PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.