Two-Tunnel Transtibial Repair of Radial Meniscus Tears Produces Comparable Results to Inside-Out Repair of Vertical Meniscus Tears
Two-Tunnel Transtibial Repair of Radial Meniscus Tears Produces Comparable Results to Inside-Out Repair of Vertical Meniscus Tears
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DOI：
10.1177/0363546517704425
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发表时间：
2017-08-01
影响因子：
4.8
通讯作者：
LaPrade, Robert F.
中科院分区：
文献类型：
--
作者：
Cinque, Mark E.;Geeslin, Andrew G.;LaPrade, Robert F.
背景：放射状半月板撕裂破坏周围纤维，从而影响半月板的完整性。在历史上，放射状撕裂通常采用半月板切除术治疗，因为对这些撕裂的生物力学后果的了解不完全，修复的生物力学性能信息有限，以及修复相关的技术困难。目的/假设：目的/假设：目的是确定双隧道经胫骨修复放射状半月板损伤的结果，并将这些结果与接受垂直半月板损伤修复的患者的结果进行比较，至少随访2年。研究设计：队列研究；证据水平，3。方法：本研究包括接受双隧道经胫骨拔出修复的放射状半月板撕裂的患者，并与接受内向外修复的垂直半月板损伤的患者进行比较。在手术前进行主观问卷调查，并进行至少2年的随访，包括Lysholm评分、安大略省西部大学和麦克马斯特大学骨关节炎指数(WOMAC)、简明形式12(SF-12)身体成分摘要(PCS)、Tegner活动量表和患者满意度。使用协方差分析比较半月板修复组之间的术后结果评分，同时考虑基线评分。结果：27例接受双隧道经胫骨拔出修复的放射状半月板撕裂患者和33例接受内翻修复的垂直半月板损伤患者获得了平均3.5年(2.0~5.4年)的随访。两组患者的术前预后评分无明显差异。两组术后2年的任何一项结果评分均无显著差异。相对于垂直修复组，放射状修复组在SF-12 PCS、WOMAC和Lysholm评分上的调整平均分分别为-0.2(95%CI，-5.4~4.9)、-0.6(95%CI，-6.6~5.5)和5.1(95%CI，-3.9~14.0)分，结论：在平均3.5年的随访期内，双隧道经胫骨拔出技术修复放射状半月板撕裂与修复垂直半月板撕裂的临床结果相似。
Background: Radial meniscus tears disrupt the circumferential fibers and thereby compromise meniscus integrity. Historically, radial tears were often treated with meniscectomy because of an incomplete understanding of the biomechanical consequences of these tears, limited information regarding the biomechanical performance of repair, and the technical difficulty associated with repair. There is a paucity of studies on the outcomes of the repair of radial meniscus tears.Purpose/Hypothesis: The purpose was to determine the outcomes of 2-tunnel transtibial repair of radial meniscus tears and compare these results to the outcomes of patients who underwent the repair of vertical meniscus tears with a minimum of 2-year follow-up. The hypothesis was that radial and vertical meniscus tear repair outcomes were comparable.Study Design: Cohort study; Level of evidence, 3.Methods: Patients who underwent 2-tunnel transtibial pullout repair for a radial meniscus tear were included in this study and compared with patients who underwent inside-out repair for a vertical meniscus tear. Subjective questionnaires were administered preoperatively and at a minimum of 2-year follow-up, including the Lysholm score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Short Form-12 (SF-12) physical component summary (PCS), the Tegner activity scale, and patient satisfaction. Analysis of covariance was used to compare postoperative outcome scores between the meniscus repair groups while accounting for baseline scores. Adjusted mean effects relative to the radial repair group were reported with 95% CIs.Results: Twenty-seven patients who underwent 2-tunnel transtibial pullout repair for radial meniscus tears and 33 patients who underwent inside-out repair for vertical meniscus tears were available for follow-up at a mean of 3.5 years (range, 2.0-5.4 years). No preoperative outcome score significantly differed between the groups. There were no significant group differences for any of the 2-year postoperative outcome scores. Relative to the vertical repair group, the radial repair group exhibited an adjusted mean of -0.2 (95% CI, -5.4 to 4.9), -0.6 (95% CI, -6.6 to 5.5), and 5.1 (95% CI, -3.9 to 14.0) points on the SF-12 PCS, WOMAC, and Lysholm scores, respectively.Conclusion: The 2-tunnel transtibial pullout technique for the repair of radial meniscus tears produces similar clinical outcomes when compared with the repair of vertical meniscus tears at a mean 3.5 years' follow- up.