Background:

Injuries to the meniscus root attachments result in extrusion of the meniscus, impaired distribution of hoop stresses, and progressive degenerative articular wear. As a result of these deleterious effects, there has been increasing emphasis on repairing meniscus root injuries to restore structure and function.

Purpose:

To describe meniscus root tear patterns, associated injuries, and outcomes of transosseous meniscus root repair in a series of pediatric patients.

Study Design:

Case series; Level of evidence, 4.

Methods:

A single-institution retrospective review approved by the institutional review board was performed on consecutive adolescent patients aged <19 years with a meniscus posterior root tear treated with transosseous root repair over 4 years. All patients had a minimum 24-month clinical follow-up. The primary outcomes were revision meniscal surgery, and Lysholm, patient satisfaction, and Tegner activity scores.

Results:

A total of 20 patients (11 male and 9 female patients), with a mean age of 15.6 years (range, 13-18 years), met the inclusion criteria. There were 14 lateral meniscus root tears and 6 medial meniscus root tears. Seventeen patients (85%) had an associated ligament tear: 12 anterior cruciate ligament (ACL) tears and 5 posterior cruciate ligament tears. Two root tears occurred in isolation and both were the posterior root of the medial meniscus. The majority of meniscus root tears (n = 14 patients; 70%) were root avulsions (type 5). The mean follow-up was 42 months (range, 25-71 months). One patient underwent secondary surgery on the affected meniscus after a new injury 4 years postoperatively. Patient-reported outcomes were obtained for 16 patients (80%) at a mean 54-month follow-up. The median Lysholm score was 95 (interquartile range [IQR], 90-100). The median patient satisfaction score was 10 (IQR, 8-10). Thirteen of 16 patients (81%) reported returning to the same or higher level of sports after surgery.

Conclusion:

Meniscus root tears most commonly occur in pediatric patients as root avulsions of the posterior root of the lateral meniscus and in association with ACL tears. This is unique compared with the adult population, in which the medial meniscus posterior root is often injured in isolation from a radial tear adjacent to the root. In our pediatric case series, transosseous root repair resulted in successful outcomes in the majority of patients, with durable results at the midterm follow-up.

中文翻译：

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儿科患者的经骨半月板根修复与持久的中期结果和高运动恢复率相关

背景：

半月板根部附件的损伤导致半月板挤压、环向应力分布受损和进行性退行性关节磨损。由于这些有害影响，人们越来越重视修复半月板根损伤以恢复结构和功能。

目的：

描述一系列儿科患者的半月板根撕裂模式、相关损伤和经骨半月板根修复的结果。

学习规划：

案例系列；证据水平，4。

方法：

一项由机构审查委员会批准的单机构回顾性审查对年龄<19 岁的半月板后牙根撕裂的连续青少年患者进行了超过 4 年的经骨根修复治疗。所有患者都进行了至少 24 个月的临床随访。主要结果是半月板翻修手术、Lysholm、患者满意度和 Tegner 活动评分。

结果：

共有20例患者（男性11例，女性9例），平均年龄15.6岁（范围13-18岁）符合纳入标准。外侧半月板根撕裂14个，内侧半月板根撕裂6个。17 名患者 (85%) 有相关韧带撕裂：12 名前交叉韧带 (ACL) 撕裂和 5 名后交叉韧带撕裂。两根撕裂单独发生，均为内侧半月板后根。大多数半月板根部撕裂（n = 14 名患者；70%）是根部撕脱（5 型）。平均随访时间为 42 个月（范围 25-71 个月）。一名患者在术后 4 年再次受伤后对受影响的半月板进行了二次手术。在平均 54 个月的随访中，16 名患者 (80%) 获得了患者报告的结果。Lysholm 评分中位数为 95（四分位距 [IQR]，90-100)。患者满意度评分中位数为 10（IQR，8-10）。16 名患者中有 13 名（81%）报告说术后恢复到相同或更高水平的运动。

结论：

半月板根撕裂最常见于儿科患者，因为外侧半月板后根的根部撕脱并与 ACL 撕裂有关。与成年人群相比，这是独一无二的，在成年人群中，内侧半月板后根经常因邻近根部的径向撕裂而受伤。在我们的儿科病例系列中，经骨根修复在大多数患者中取得了成功的结果，在中期随访中取得了持久的结果。