[1]陈博,王庆帅,张智乘,等.外侧半月板后根修复对前交叉韧带重建后膝关节稳定性的影响[J].中华老年骨科与康复电子杂志,2024,(01):19-27.[doi:10.3877/cma.j.issn.2096-0263.2024.01.004]
　Chen Bo,Wang Qingshuai,Zhang Zhicheng,et al.The effect of lateral meniscus posterior root repair on the stability of anterior cruciate ligament reconstructed knee[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2024,(01):19-27.[doi:10.3877/cma.j.issn.2096-0263.2024.01.004]
点击复制

外侧半月板后根修复对前交叉韧带重建后膝关节稳定性的影响()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2024年01期
页码:
19-27
栏目:
关节
出版日期:
2024-02-05

文章信息/Info

Title:
The effect of lateral meniscus posterior root repair on the stability of anterior cruciate ligament reconstructed knee
作者:
陈博; 王庆帅; 张智乘; 李颖智
130000 吉林大学第二医院运动医学与关节镜科
Author(s):
Chen Bo;  Wang Qingshuai;  Zhang Zhicheng;  Li Yingzhi
Department of Sports Medicine and Arthroscopy, Second Hospital of Jilin University, Changchun 130000, China
关键词:
外侧半月板后根撕裂;  前交叉韧带撕裂;  胫骨前半脱位;  半月板外突;  胫骨结节-滑车沟间距
Keywords:
Lateral meniscal posterior root tear;  Anterior cruciate ligament tear;  Anterior tibial subluxation;  Meniscal extrusion;  Tibial tubercle-trochlear groove distance
DOI:
10.3877/cma.j.issn.2096-0263.2024.01.004
文献标志码:
A
摘要:
目的 评估外侧半月板后根修复或部分切除对前交叉韧带（ACL）重建后膝关节稳定性的影响是否存在差异。方法 回顾性收集2018年6月至2022年3月经关节镜诊断为ACL撕裂合并外侧半月板后根撕裂（LMPRT）的患者，根据不同术式分为2组，A组行ACL重建+LMPR修复；B组行ACL重建+LMPR部分切除术。此外，随机匹配同时期单纯ACL撕裂行ACL重建患者作为对照组（C组）。所有患者随访12个月以上。根据Lysholm评分、国际膝关节评分委员会（IKDC）评分评估膝关节客观功能，通过轴移试验、基于MRI测量的胫骨前半脱位（ATS）、外侧半月板外突（LME）、胫骨结节-滑车沟（TT-TG）间距、股骨胫骨旋转（FTR）角评估膝关节稳定性。结果 共纳入患者45例，男性30例，女性15例，平均年龄（33.98±11.00）岁，随访时间（14.54±1.88）个月。与术前相比，末次随访时各组患者Lysholm评分、IKDC评分、ATS、TT-TG与FTR结果均显著改善（P＜0.05）；A组末次随访时LME与术前相比存在显著改善（P＜0.05）。组间比较：（1）术前，C组的Lysholm评分、IKDC评分、轴移试验结果、ATS、LME等指标显著优于A、B两组（P＜0.05）；各组TT-TG和FTR无显著差异（P＞0.05）。（2）术后，B组轴移试验显著强于A、C两组（P＜0.05），A、C两组的轴移试验无显著差异（P＞0.05）。（3）末次随访时，A、C两组的自主功能评分和LME均显著优于BB组（P＜0.05）；B组ATS显著高于C组（P＜0.05）；A组与C组患者自主功能评分、ATS、LME均无显著差异（P＞0.05）；各组TT-TG与FTR无显著差异（P＞0.05）。结论 LMPRT修复可进一步提高ACL重建后膝关节的前向和旋转稳定性，并减少LME，提高患者自主功能评分。
Abstract:
Objective This study was to investigate the effect of stability of the anterior cruciate ligament (ACL)-reconstructed knee between lateral meniscus posterior root (LMPRT) repair and partial meniscectomy. Methods The patients with ACL tear and LMPR injury were enrolled in this study (group A: ACL reconstruction+LMPR repair, 17 patients; group B: ACL reconstruction+LMPR partial meniscectomy, 10 patients). At the same time, the patients who underwent ACL reconstruction for simple ACL tear were randomly matched as the control group (group C). All patients had at least 12-month follow-up. Lysholm score and International Knee Documentation Committee (IKDC) score were used to assess the knee function of the patients. The physical examination was assessed using the pivot shift test. Anterior tibial subluxation (ATS), lateral meniscal extrusion (LME), Tibial Tubercle-Trochlear Groove (TT-TG) distance, femorotibial rotation (FTR) angle, and the lateral compartment cartilage of the knee were assessed via magnetic resonance imaging (MRI). Results A total of 45 patients were enrolled in this study, with 30 males and 15 females, and an average age of (33.98±11.00) years. The follow-up period was (14.54±1.88) months. Compared to the preoperative measurements, at the latest follow-up, patients in all groups demonstrated significant improvements in Lysholm scores, IKDC scores, ATS, TT-TG, and FTR results (P<0.05). There was a significant difference in the degree of preoperative LME in group A patients compared with the values of the last follow-up (P<0.05). Intergroup comparison: (1) Preoperatively, there were significant differences in Lysholm score, IKDC score, pivot shift test, ATS, and LME in group C compared with groups A and B (P<0.05), and there was no significant difference in TT-TG and FTR in each group (P>0.05). (2) Postoperatively, there was a significant difference in the results of the pivot shift test in group B compared with groups A and C (P<0.05), and there was no significant difference in the results of the pivot shift test between groups A and C (P>0.05). (3) At the last follow-up, there were significant differences in the patient-reported scores and LME in group B compared with groups A and C (P<0.05). There was a significant difference between group B and group C in ATS, and there was no significant difference between group A and group C in patient-reported scores, ATS, and LME (P>0.05). There was no significant difference in TT-TG and FTR in each group (P> 0.05). Conclusions LMPRT repair further improves the anterior and rotational stability of the ACL-reconstructed knee, leading to reduced the LME, and improves the patient-reported scores.

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（U21A20390）
更新日期/Last Update: 2024-08-01