Repair of locked bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency
Repair of locked bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency
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DOI：
10.1177/03635465030310021001
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发表时间：
2003-03-01
影响因子：
4.8
通讯作者：
Shelbourne, KD
中科院分区：
文献类型：
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作者：
O'Shea, JJ;Shelbourne, KD
背景：慢性前交叉韧带缺乏的膝关节大桶柄半月板撕裂被认为是无血管的，因此是不可修复的。假设：半月板愈合率高于先前报道。研究设计：前瞻性队列研究。方法：59例患者分阶段接受半月板修复手术，术后平均77 +/- 58天进行韧带重建。结果：52例半月板修复55例，可随访。重建时，30例（55%）半月板愈合；部分愈合19例（34%）；6例（11%）无愈合（仅4例切除）。在43个白对白区域的眼泪中，有21个看起来愈合了；17、部分愈合；5例没有愈合。在红白相间区域的11个病人中，有8个似乎痊愈了；2、部分愈合；我没有痊愈的迹象。一个半月板撕裂在红色对红色区域似乎愈合。在平均4.3±3.1年的随访中，43例白对白半月板修复中有36例（83.7%）仍无症状；其他区域的所有修复均无症状。结论：闭锁桶柄半月板撕裂在孤立修复时愈合率高，即使在重建前允许完全负重和活动，撕裂位于白对白区。(C) 2003年美国骨科学会运动医学。
Background: Large bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency have been considered avascular and, thus, irreparable.Hypothesis: The rate of meniscal healing is higher than previously reported.Study Design: Prospective cohort study.Methods: Fifty-nine patients underwent staged surgical procedures of meniscal repair followed at an average of 77 +/- 58 days by ligament reconstruction once full range of motion was obtained.Results: Fifty-two patients with 55 meniscal repairs were available for follow-up. At reconstruction, 30 menisci (55%) appeared healed; 19 (34%), partially healed; and 6 (11%) showed no healing (only 4 were removed). Of 43 tears in the white-on-white zone, 21 appeared healed; 17, partially healed; and 5 showed no healing. Of 11 in the red-on-white zone, 8 appeared healed; 2, partially healed; and 1 showed no healing. One meniscal tear in the red-on-red zone appeared healed. At an average follow-up of 4.3 +/- 3.1 years, 36 of the 43 (83.7%) white-on-white meniscal repairs remained asymptomatic; all repairs in the other zones remained asymptomatic.Conclusion: Locked bucket-handle meniscal tears heal at a high rate when repaired as an isolated procedure, even when full weightbearing and activity before reconstruction is allowed and when the tear is in the white-on-white zone. (C) 2003 American Orthopaedic Society for Sports Medicine.