全内与由内向外半月板修复术：愈合率与功能结局的比较研究
简介
该前瞻性研究纳入50例半月板撕裂患者，比较全内与由内向外修复术的愈合率及功能结果。全内组手术时间更短（42 vs 58分钟）、并发症更少，但由内向外组愈合率略高（92% vs 84%）；两组Lysholm和IKDC评分均显著改善。提示全内修复在效率与安全性上具优势，但由内向外技术可能愈合更佳。
英文摘要
INTRODUCTION: Meniscal injuries rank as one of the most frequent knee injuries, which can be repaired through preservation as the best method to maintain knee joint health and prevent long-term joint deterioration. The all-inside and inside-out meniscal repair techniques represent the most commonly used surgical methods for meniscal tissue restoration. The existing research shows ongoing disagreement about which method of treatment produces better healing results and functional improvements, and surgical time efficiency and rate of medical complications. MATERIALS AND METHODS: This prospective comparative study included 50 patients with meniscal tears who underwent arthroscopic repair. Patients were divided into two groups: All-inside repair (n = 25) and inside-out repair (n = 25). Demographic data, tear characteristics, operative time, complications, healing rates, and functional outcomes were assessed. Functional outcomes were evaluated using the Lysholm knee score and the International Knee Documentation Committee (IKDC) score. Patients were followed up for 6 months postoperatively. RESULTS: Majority of the patients were aged 26-35 years (38%) with a male predominance (70%). Operative time was significantly lower in the all-inside group (42 ± 6 min) compared to the inside-out group (58 ± 8 min). Meniscal healing was observed in 84% of patients in the all-inside group and 92% in the inside-out group. Functional outcomes improved significantly in both groups, with Lysholm scores increasing to 90 ± 5 (all-inside) and 92 ± 4 (inside-out), and IKDC scores to 88 ± 6 and 90 ± 5, respectively. Complications were fewer in the all-inside group, with no neurovascular injuries reported, whereas the inside-out group had a higher incidence of such complications. Return to pre-injury activity was achieved in 80% of patients overall. CONCLUSION: Both all-inside and inside-out meniscal repair techniques demonstrated excellent healing and functional outcomes. The all-inside technique provided shorter operative time and fewer complications, whereas the inside-out technique showed slightly higher healing rates.