桶柄状撕裂修复后半月板位置：全内技术与由内向外技术的多平面MRI比较
简介
83例桶柄状半月板撕裂患者行关节镜修复，MRI多平面比较全内与由内向外技术的半月板位置。内侧半月板冠状位无变化、矢状后位增约2mm；外侧冠状位更靠周边、后位增约5mm，前位不变；两种技术位置无差异，均在健侧参考范围内，Lysholm、IKDC、VAS评分均显著改善且无技术差异。提示两种修复技术短期影像与临床结果相当，术式选择可更多依据操作习惯与撕裂特征。
英文摘要
HYPOTHESIS/PURPOSE: To compare multiplanar meniscal position following all-inside and inside-out repair of bucket-handle tears using magnetic resonance imaging (MRI) and to evaluate the association between meniscal shift and short-term clinical outcomes. METHODS: A retrospective comparative study was performed on 83 patients who underwent arthroscopic repair of bucket-handle meniscal tears. Postoperative MRI was used to evaluate meniscal position in multiple planes by measuring coronal extrusion and sagittal anterior and posterior meniscal position relative to the tibial plateau borders. When available, postoperative measurements were additionally compared with MRI findings from contralateral asymptomatic knees as a patient-specific native reference. Clinical outcomes were evaluated using Lysholm, International Knee Documentation Committee (IKDC), and visual analogue scale (VAS) scores at final follow-up. Comparisons were made between all-inside and inside-out repair techniques. RESULTS: Eighty-three patients were included (45 medial, 38 lateral). In the medial meniscus, coronal position did not change significantly after repair in either technique, whereas posterior sagittal position increased by approximately 2 mm after repair regardless of repair technique (both p < 0.001). In the lateral meniscus, the meniscus shifted toward a more peripheral coronal position postoperatively in both techniques (both p < 0.001), while posterior sagittal position increased by approximately 5 mm and anterior sagittal position remained unchanged. Postoperative meniscal position was comparable between techniques and generally remained within contralateral native reference ranges. All clinical scores improved significantly without technique-dependent differences. CONCLUSION: All-inside and inside-out repair produced comparable coronal and sagittal meniscal position at 1 year after bucket-handle repair and similar clinical improvements. Postoperative meniscal position generally remained within contralateral reference ranges regardless of repair technique. No technique-dependent differences in meniscal position or clinical outcomes were identified.