盘状外侧半月板行成形缝合术后即刻残留体部宽度>13 mm者宽度缩小更快且并发症率更高
简介
该研究回顾分析了72例完全型盘状外侧半月板行成形+修复术后的患者，根据术后即刻半月板体部残留宽度分为大（>13 mm）、正常（9–13 mm）、小（<9 mm）三组。结果发现，尽管三组Lysholm评分达到最小临床重要差异的比例均很高，但残留宽度>13 mm的组别在术后2年内宽度减少更快，且并发症（再撕裂、翻修、剥脱性骨软骨炎）发生率显著高于正常组。多因素分…
英文摘要
PURPOSE: To estimate the adequate residual midbody meniscal width immediately after surgery saucerization with repair for discoid lateral meniscus (DLM) and at subsequent follow-up, and to evaluate the complication rate. METHODS: A retrospective analysis was conducted on complete DLM cases that underwent saucerization with repair from August 2017 to January 2023, with a minimum follow-up of 2 years. Knees were classified into 3 groups based on midbody meniscal width immediately after surgery: large (>13 mm), normal (9 to ≤13 mm), and small (<9 mm). Changes in residual meniscal width over time and complications such as retear, revision surgery, and postoperative osteochondritis dissecans were assessed. The minimum clinically important difference of the Lysholm score was calculated. Demographic data and meniscal width immediately after surgery were analyzed for associations with greater than a 50% reduction in residual midbody width from 0 to 24 months using logistic regression analyses. RESULTS: Seventy-seven knees of 72 patients were reviewed in this study. The minimum clinically important difference achievement rate was 98.7%, with no significant difference among the 3 groups. The complication rate in the large group was significantly higher than in the normal group (P = .026). On multivariate analysis, greater midbody meniscal width at 0 months (odds ratio, 1.38; P = .006) was identified as a risk factor for >50% reduction in residual midbody width, with a cutoff value of 11.5 mm. CONCLUSIONS: Although clinical outcomes showed favorable minimum clinically important difference achievement regardless of meniscus size, a residual midbody meniscal width >13 mm immediately after surgery decreased faster than smaller widths and had greater complication rate in DLM treated with saucerization and repair. LEVEL OF EVIDENCE: Level IV, retrospective case series.