隧道内锚钉固定与经胫骨拉出式修复在半月板根部修复术后短期疗效相当：一项倾向性匹配对比研究
简介
这项倾向性评分匹配的回顾性研究比较了隧道内锚钉固定与经胫骨隧道拉出修复治疗半月板根部撕裂的短期疗效。两组再手术率（8% vs 14%）、修复失败率及Lysholm/IKDC评分均无显著差异，患者满意度高，但锚钉组活动痛VAS略低、PASS达标率更高。提示两种术式短期临床结果和再手术率相当。
英文摘要
PURPOSE: To compare short-term outcomes of intratunnel anchor fixation versus transtibial pull-through repair for meniscus root tears with a minimum of 12-month follow-up. METHODS: Patients who underwent primary meniscus root repair between 2011 and 2024 at a single institution were retrospectively reviewed. Inclusion criteria consisted of primary medial or lateral meniscus root repair using either intratunnel anchor fixation or transtibial pull-through repair, availability of preoperative radiographs, and completion of postoperative patient-reported outcome measures with a minimum of 12-month follow-up. The groups were propensity-matched by age, sex, body mass index, operative side, root laterality, and concomitant procedures. Baseline radiographic characteristics (hip-knee-ankle angle and posterior tibial slope) were measured. Outcomes included Lysholm score, International Knee Documentation Committee score, Tegner activity score (preoperative and postoperative), Visual Analog Scale for pain at rest and with activity, satisfaction, subjective surgical outcome, and reoperations. RESULTS: Fifty patients who underwent intratunnel anchor fixation (mean age, 44 years) were propensity-matched to 100 patients who underwent transtibial pull-through repair (mean age, 41 years). Mean follow-up was 1.5 years (range, 1.0-2.3) in the intratunnel anchor group and 6.1 years (range, 2.7-13.7) in the transtibial pull-through group. Reoperation rates were 8% and 14%, respectively (P = .43), with repair failure occurring in 4% and 6% (P > .99). Preoperative and postoperative Tegner scores were similar between groups. Tegner minimal clinical important difference was 0.8, and 26.5% of intratunnel anchor patients achieved this compared with 0% of transtibial pull-through patients. Patients in the intratunnel anchor cohort reported slightly lower Visual Analog Scale pain with activity (1.8 vs 2.5, P = .02). Postoperative Lysholm (87 vs 83, P = .05) and International Knee Documentation Committee scores (79 vs 76, P = .09) were comparable between groups. A greater proportion of intratunnel anchor patients achieved Patient Acceptable Symptomatic State compared with transtibial pull-through patients for Visual Analog Scale with activity (74% vs 56%, P = .03) and Lysholm (66% vs 47%, P = .01). Most patients in both cohorts rated their outcome as "much better" or "slightly better" (P = .49), and satisfaction scores were high. CONCLUSIONS: At short-term follow-up, both the intratunnel anchor and transtibial pull-through techniques showed high patient satisfaction and comparable overall clinical outcomes. There were no differences in reoperation rates between techniques. LEVEL OF EVIDENCE: Level III, retrospective comparative case series.