Abstract

Purpose

To compare the clinical outcomes of meniscus repair and meniscus resection with concurrent anterior cruciate ligament (ACL) reconstruction in patients with ACL rupture and neglected or delayed medial meniscus tears.

Methods

Thirty patients with ACL ruptures and unstable vertical longitudinal medial meniscus tears were included. Patients were divided into two groups. Group I included 15 patients who underwent meniscal repair and Group II included 15 patients who underwent meniscectomy. The knee range of motion, McMurray test, Lachman test, pivot shift test, Lysholm Knee Scoring Scale, International Knee Documentation Committee (IKDC) Questionnaire, Hospital for Special Surgery (HSS) Knee score, and Tegner activity (TA) scale were used to assess all patients.

Results

The median follow-up time was 3.6 (0.5–6.5) years. Median age was 28 (16–36) years. Fourteen patients (93.3%) in Group I and six patients (40%) in Group II returned to their preinjury sport activity level (P = .007). Median maximum knee flexion was 132° (121°–140°) in Group I and 134° (121°–139°) in Group II (n.s.). All patients had full knee extension and negative McMurray test results. Lachman and pivot shift test results were similar between groups. The median IKDC Questionnaire score was 99 (86–100) in Group I and 93 (70–100) in Group II (P = .016). The difference in Lysholm Knee Scoring Scale, HSS knee, and TA scale score between groups were not significant.

Conclusion

Clinical outcomes of patients that underwent meniscus repair were better than those that underwent meniscus resection with concurrent ACL reconstruction. The technically complicated and costly meniscus repair may achieve better clinical outcomes than meniscectomy when treating a neglected or delayed meniscal tear with a concurrent ACL tear.

Level of evidence

III.

中文翻译：

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延迟或被忽视的半月板撕裂修复和半月板切除术以及ACL重建具有相似的临床效果

摘要

目的

为了比较半月板断裂和被忽视或延迟的半月板内侧撕裂的患者半月板​​修复和半月板切除与同时前交叉韧带（ACL）重建的临床结果。

方法

包括30例ACL破裂和垂直半月板内侧纵向不规则撕裂的患者。患者分为两组。第一组包括15例行半月板修复术，第二组包括15例行半月板切除术。膝关节活动范围，McMurray检验，Lachman检验，枢轴移位检验，Lysholm膝关节评分量表，国际膝关节文献委员会（IKDC）问卷，特殊外科医院（HSS）膝关节评分和Tegner活动度（TA）量表用于评估所有患者。

结果

中位随访时间为3.6（0.5–6.5）年。中位年龄为28（16–36）岁。第一组中的十四名患者（93.3％）和第二组中的六名患者（40％）恢复到损伤前的运动水平（P  = .007）。I组最大膝关节屈伸中值为132°（121°–140°），II组为134°（121°–139°）（ns）。所有患者的膝关节完全伸展，McMurray测试结果阴性。两组之间的Lachman和枢轴位移测试结果相似。第一组的IKDC问卷中位数为99（86-100），第二组为93（70-100）（P  = 0.016）。两组之间的Lysholm膝关节评分量表，HSS膝关节评分和TA量表评分差异不显着。

结论

进行半月板修复的患者的临床结局要好于同时进行ACL重建的半月板切除的患者。当治疗被忽视或延迟的半月板撕裂并发ACL撕裂时，技术复杂且昂贵的半月板修复可能比半月板切除术获得更好的临床效果。

证据水平

三，