Clinical results of meniscus repair in patients 40 years and older
Clinical results of meniscus repair in patients 40 years and older
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DOI：
10.1016/s0749-8063(98)70018-0
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发表时间：
1998-11-01
期刊：
影响因子：
4.7
通讯作者：
Ruff, CG
中科院分区：
文献类型：
--
作者：
Barrett, GR;Field, MH;Ruff, CG
半月板在膝关节中发挥的关键作用沿着尽可能多地保留半月板的优点已经得到充分的证明。只要有可能，半月板修复已成为治疗半月板撕裂的首选手术。然而，一些研究人员报告了老年患者的不利结果。为了确定老年患者半月板修复的结果，对40岁及以上接受关节镜辅助半月板修复的患者进行了前瞻性随访。37例患者入组研究，所有患者均接受了至少2年的随访（平均26.5个月）。患者在修复时的平均年龄为44.2岁（范围：40 - 52岁）; 26例为男性，11例为女性。本研究纳入了19例左侧膝关节和18例右侧膝关节。22例患者进行了相关的前交叉韧带重建。随访时的体格检查包括肿胀、关节线压痛、交锁、McMurray试验和X线片。在最近的随访中，5/37例（13.5%）经修复的脊髓损伤有症状。所有这些患者都有关节线触痛，其中2例McMurray试验阳性。其中3名患者接受了再次关节镜检查，证实半月板未愈合。由于随访时出现症状的患者数量较少，作者认为40岁及以上患者的半月板修复术是治疗外周半月板撕裂的有效方法。86.5%的患者具有良好的临床结果，这些结果与其他针对年轻人群的研究相当，表明该年龄组适用于外周撕裂修复，尤其是与前交叉韧带重建联合使用。研究结果表明，位置和尿道撕裂，而不是患者的年龄，决定了成功修复的可能性。
The critical role that the meniscus plays in the knee along with the advantages of preserving as much of the meniscus as possible have both been well documented. Whenever possible, meniscus repair has become the procedure of choice for treatment of meniscal tears. However, some researchers have reported less favorable results in older patients. To determine the results of meniscus repair in older patients, patients 40 years and older who underwent arthroscopically assisted meniscus repair were prospectively followed up. Thirty-seven patients were included in the study, all of which had a minimum 2-year follow-up (average, 26.5 months). The average age of the patients at the time of the repair was 44.2 years (range, 40 to 52 years); 26 were males and 11 were females. There were 19 left knees and 18 right knees included in the study. Twenty-two patients had associated anterior cruciate ligament reconstructions. Physical examination at follow-up included swelling, joint line tenderness, locking, and McMurray testing and radiographs. Five of 37 menisci repaired (13.5%) were symptomatic at latest follow-up. All of these patients had joint line tenderness and two had a positive McMurray test. Three of these patients had repent arthroscopy confirming that the meniscus had not healed. Because of the small number of patients with symptoms at follow-up, the authors feel that meniscus repair in patients 40 years and older is an effective treatment for peripherally located meniscus tears. With 86.5% of the patients having good clinical results, these findings are comparable with other studies with a younger population and signify that repair of peripheral tears is indicated in this age group especially in conjunction with anterior cruciate ligament reconstruction. The findings suggest that the location and meniscal tear, rather than the age of the patient, determine the potential for successful repair.