前交叉韧带重建术中同期行后内侧半月板根部修复：非退变性队列的临床结局、膝关节稳定性及再手术率
简介
该研究回顾性分析了23例非退变性膝关节患者，在ACL重建同期行关节镜下内侧半月板后根部修复术的2年随访结果。术后患者KOOS评分总体可接受，70.6%达到PASS标准，膝关节前向稳定性满意，但20%出现伸膝受限，43.5%因关节纤维化等并发症接受再手术。提示该联合术式可获得可接受的临床结局，但缺乏对照组，且高再手术率主要与ACL重建相关而非半月板失败。
英文摘要
OBJECTIVES: To evaluate patient-reported outcomes, knee stability, and reoperation rates after repair of posterior medial meniscus root tears (PMMRTs) performed concomitantly with anterior cruciate ligament reconstruction (ACLR) in a nondegenerative patient population. METHODS: This retrospective cohort study included patients who underwent arthroscopic PMMRT repair in conjunction with ACLR between 2015 and 2022, at a high-volume tertiary referral center for orthopedic sports medicine. Patients with prior meniscal surgery or radiographic or arthroscopic signs of degenerative joint disease were excluded. Patient-reported outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS) at 2-year follow-up. Patient Acceptable Symptom State (PASS) and Treatment Failure (TF) thresholds were applied. Objective outcomes included range of motion (ROM), anterior knee laxity, and isokinetic strength at 6 months. Reoperations during follow-up were recorded. RESULTS: Twenty-three patients were included, of whom 17 (73.9%) had available KOOS data at 2 years. Six-month clinical assessment data were available for 20 of 23 patients (87.0%). Mean KOOS scores were 84.1 for Pain, 76.1 for Symptoms, 90.4 for Activities of Daily Living, 60.4 for Sport and Recreation, and 68.9 for Quality of Life. Overall, 70.6% of patients achieved PASS, while 11.7% met criteria for treatment failure. Anterior knee laxity improved postoperatively, with no patients demonstrating a side-to-side difference greater than 5 mm at 6 months. Extension deficits greater than 5° were observed in 20% of patients. During follow-up, 43.5% of patients underwent additional surgical procedures, most commonly for arthrofibrosis-related conditions. No anterior cruciate ligament revisions or clinically detected re-ruptures of the repaired meniscal root were identified. CONCLUSION: In this cohort of patients with nondegenerative knees undergoing concomitant PMMRT repair and ACL reconstruction, acceptable patient-reported outcomes, satisfactory knee stability, and no clinically detected root failures were observed. Reoperations were common and primarily related to ACL reconstruction rather than meniscal failure. Due to the absence of a control group, the specific contribution of PMMRT repair to these outcomes cannot be determined. LEVEL OF EVIDENCE: IV.