全内侧修复桶柄状撕裂和全层放射状撕裂的中期疗效良好，存活率超过80%
简介
本研究回顾性分析了55例接受关节镜下全内修复的半月板桶柄样撕裂（BHT）和全层放射状撕裂（RT）患者（平均随访>2年）。结果显示，总体中期失败率为17.8%（4年累积），患者满意度高达97.9%，重返运动率达87.2%。关键发现：内侧BHT（失败率35.5%）和退变性撕裂失败风险显著更高；而同期行ACL重建的修复失败率更低。结论支持对符合条件的BHT和RT进…
英文摘要
PURPOSE: To evaluate failure rates, survivorship, patient-reported outcome measurements (PROMs), and prognostic factors following all-inside arthroscopic repair of bucket-handle tears (BHT) and full-thickness radial meniscal tears (RT). METHODS: A retrospective cohort study included consecutive patients undergoing all-inside repair of BHT or RT by a single surgeon (2019-2025) with a minimum 2-year follow-up. Inclusion required primary repair using all-inside devices. Demographic data, tear morphology, chronicity, and concomitant procedures were recorded. Failure was defined as surgical re-intervention or magnetic resonance imaging-confirmed re-tear. PROMs included subjective International Knee Documentation Committee (IKDC), Tegner Activity Scale, Patient Acceptable Symptom State (PASS), and Visual Analog Scale (VAS) scores. Return to sport (RTS) rates and the achievement of IKDC-PASS threshold were assessed. Kaplan-Meier survival analyses for each lesion type were performed at 1, 2, 3, and 4 years; subgroup comparisons (location, ACL reconstruction, aetiology) were performed using the log-rank test. RESULTS: Fifty-five repairs (34 BHTs, 21 RTs; 72.7% males; mean age 27.0 ± 11.7 years) were analysed. BHTs were medial in 24 cases and lateral in 10; all RTs were lateral. Overall, 52.7% were chronic, 54.6% treated with concomitant ACL reconstruction, and 83.7% were traumatic. Five repairs failed (mean 22.3 ± 11.9 months), yielding cumulative failure rates of 0.0% at 1 year, 6.0% at 2 years, 8.7% at 3 years and 17.8% at 4 years. Failures were more frequent in medial BHTs (35.5%), degenerative tears (p = 0.0194) and isolated repairs (p = 0.0321). Overall satisfaction was 97.9%, with 87.2% patients returning to sport and 48.9% reaching their preinjury level. CONCLUSIONS: Meniscal repair of BHTs and RTs achieved 98% patient satisfaction and high return-to-sport rates with a 17% mid-term failure. Medial BHTs and degenerative lesions demonstrated a higher risk of failure, whereas repairs performed concomitantly with ACL reconstruction showed lower failure rates. These findings support early repair and highlight the importance of tear pattern, aetiology, lesion chronicity and concomitant procedures in predicting outcomes. LEVEL OF EVIDENCE: Level IV, therapeutic case series.