背景:在不可减少的桶形手柄内侧半月板撕裂(BHMMT)中,移位的中央碎片旋转180°或更多,意味着没有撕裂的降低是不可能的。在慢性病例中,旋转的弯月面变形和退化;因此,再现性和可修复性的问题出现了。这项研究提出了慢性不可还原和不稳定锁定BHMMT的临床结果。还使用磁共振成像(MRI)评估了放射学结果。
方法:本研究是对2011年至2016年手术治疗的37例不可还原型BHMMT和26例不可还原但不稳定的慢性BHMMT患者的回顾性研究。在使用临时针固定技术进行临时半月板固定后进行后关节镜检查。在使用全内技术完成垂直床垫缝线的后部修复后,对半月板的前三分之一进行了经典的外向内技术。Lysholm,国际膝关节文献委员会(IKDC)术前和最新随访时获得所有患者的Tegner活动评分。术前和术后6个月使用MRI进行放射学评估。
结果:在2011年至2016年之间,共有37例不可还原和慢性BHMMT的连续患者接受了手术。术后平均随访7.2±1.4年(平均值±SD)。术后Lysholm(89.57±2.7)和IKDC(87.22±3.2)评分与术前评分(分别为38.44±4.5和23.52±7.8)相比,在末次随访时显着改善。根据Tegner活动量表,与末次随访时的术前水平相比,患者术后活动水平保持不变.
结论:本研究中提出的全内侧后缝合和内外侧前内侧缝合技术在用于修复慢性不可还原或不稳定BHMMT时,可产生优异的临床效果。
方法:四级。
BACKGROUND: In irreducible bucket-handle medial meniscal tears (BHMMTs), the displaced central fragment is rotated 180° or more, meaning reduction is impossible without derotation of the tear. In chronic cases, the rotated meniscus is deformed and degenerated; thus, the issue of reproducibility and repairability arises. This study presents the clinical outcomes of chronic irreducible and unstable locked BHMMTs. Radiological outcomes were also evaluated using magnetic resonance imaging (MRI).
METHODS: This is a retrospective study of 37 patients with 11 cases of irreducible BHMMT and 26 cases of reducible but unstable chronic BHMMT who underwent operations between 2011 and 2016. Posterior arthroscopy was performed after temporary meniscus fixation using a provisional needle fixation technique. After the posterior repair with vertical mattress sutures was completed using an all-inside technique, the classic outside-in technique was performed for the anterior third of the meniscus. The Lysholm, International Knee Documentation Committee (IKDC), and Tegner activity scores were obtained from all patients before surgery and at the latest follow-up. Radiological evaluations were performed using MRI before surgery and at 6 months postoperatively.
RESULTS: Between 2011 and 2016, a total of 37 consecutive patients with irreducible and chronic BHMMTs underwent surgery. The average postoperative follow-up was 7.2 ± 1.4 years (mean ± SD). Postoperative Lysholm (89.57 ± 2.7) and IKDC (87.22 ± 3.2) scores improved significantly at the last follow-up when compared with the pre-operative scores (38.44 ± 4.5 and 23.52 ± 7.8, respectively). According to the Tegner activity scale, patients\' postoperative activity levels remained unchanged compared to preoperative levels at the last follow-up.
CONCLUSIONS: Posterior knee arthroscopy with the all-inside posterior suture and inside-out anteromedial suture technique presented in this study yielded excellent clinical outcomes when used to repair chronic irreducible or unstable BHMMTs.
METHODS: Level IV.