ACL重建术中同时行外侧半月板后根修复可恢复膝关节稳定性且效果与单纯ACL重建相当：一项倾向评分匹配队列分析
简介
本研究回顾性分析了41例ACL重建（ACLR）同期行外侧半月板后根（LMPR）修复的患者，并与20例单纯ACLR患者进行倾向评分匹配比较，旨在评估联合手术的疗效。结果显示，两组患者术后膝关节稳定性（轴移试验、KT-1000测量）均较术前显著改善，且组间无差异。患者报告结局（IKDC、Lysholm、Tegner评分）在两组间也无统计学差异。LMPR修复愈合率…
英文摘要
PURPOSE: To compare clinical and MRI outcomes as well as knee anterior-posterior (AP) and rotational stability between ACL reconstructions (ACLR) with concomitant lateral meniscus posterior root (LMPR) repair and matched isolated ACLR, while assessing whether different LMPR tear patterns affect post-operative stability, healing or meniscal extrusion. METHODS: A retrospective review was performed on patients < 55 years old who underwent ACLR and LMPR repair between 2018 and 2022, with minimum 2-year follow-up. Patients with osteoarthritis, prior meniscal or cartilage surgery, revision ACLR, or multi-ligament injuries were excluded. The LMPR group was stratified into oblique radial (I), longitudinal/T-type (II), and avulsion (III) tears. A 2:1 propensity score-matched control cohort of isolated ACLR was created. Pre- and post-operative knee stability (pivot shift, KT-1000), PROMs (IKDC, Lysholm, Tegner), LMPR healing, lateral meniscus extrusion (LME), and MRI parameters (posterior meniscofemoral ligament) pMFL, (lateral femoral notch sign) LFNS were analysed. RESULTS: Forty-one LMPR repairs and 20 matched controls were included. Pre-operative instability was similar between groups (pivot shift p = 0.09, KT-1000 p = 0.92). Significant improvements in pivot shift and KT-1000 were observed post-operatively in both groups (all p < 0.001), with no post-operative differences between them (pivot shift p = 0.72, KT-1000 p = 0.94). PROMs improved significantly in all groups (p < 0.001) with no post-operative group differences. Post-operative reduction of LME did not differ statistically among tear types (p > 0.05), but LME still remained slightly higher in the study group. LMPR healing was high (75.6% complete, 24.4% partial) with no failures and no difference in healing across tear patterns (p = 0.46). The presence of LFNS or pMFL was not associated with tear type or with LMPR versus control status (p > 0.05). CONCLUSION: LMPR repair performed during ACLR successfully restores knee stability, decreases LME, and achieves functional outcomes similar to isolated ACLR. Tear morphology does not significantly affect post-operative clinical or magnetic resonance imaging results. LEVEL OF EVIDENCE: Level III, retrospective comparative study.