社论评论：根部修复只是第一步：步态正常化的未尽之功
简介
这篇编辑评论指出，内侧半月板后根修复可改善症状（修复组达可接受状态71.4%–81.0%，未修复组10.5%–26.3%），但步态力学未完全正常：支撑中期膝伸展、支撑末期膝内收力矩仍异常，修复组居中，varus thrust和内旋减少持续存在。作者强调应行动态步态评估而非仅静态X线片，并重视术后完全伸直与股四头肌恢复；仅固定不足以实现步态正常化及长期软骨保护…
英文摘要
Medial meniscus posterior root repair improves symptoms and function, but repair alone does not normalize gait. In the referenced study, patients who underwent repair achieved an acceptable symptom state more often than those with an unrepaired tear (71.4%-81.0% vs 10.5%-26.3%). Gait mechanics moved toward normal but did not reach it: compared with controls, the tear group differed significantly in midstance knee extension and terminal-stance knee adduction moment, with the repair group falling at an intermediate level. Varus thrust and reduced internal rotation persisted in both groups despite only modest differences in static mechanical alignment. This underscores that dynamic gait assessment, not a static radiograph, is beneficial to fully assess the effect of root repair. Restoration of full extension and objectively confirmed quadriceps recovery may be essential to closing this gap and to long-term chondroprotection. This raises a rehabilitation paradox: prolonged protection safeguards healing but may potentiate quadriceps inhibition and persistent gait dysfunction. Earlier controlled weightbearing, potentially supported by meniscal centralization with multiple fixation points, warrants a prospective study. Root preservation should extend beyond fixation alone to include gait restoration, extrusion control, and long-term joint protection.