Background:

Independent transtibial pullout repair is a common surgical technique for repairing lateral meniscus posterior root tears (LMPRTs). The shared anterior cruciate ligament (ACL) bone tunnel technique is an alternative technique for LMPRT repair combined with ACL reconstruction (ACLR) to avoid the establishment of additional bone tunnels.

Purpose:

To compare the clinical outcomes of the shared ACL bone tunnel versus the independent transtibial pullout techniques for LMPRT repair combined with ACLR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Between March 2014 and February 2018, a total of 48 patients were diagnosed with ACL injury with concomitant LMPRT; 22 patients underwent independent transtibial pullout repair (group T), and 26 patients underwent the shared ACL bone tunnel technique (group S). At a follow-up of >2 years, we compared knee functional recovery using the Lysholm, Tegner, and International Knee Documentation Committee scores and the pivot-shift test. Lateral meniscal extrusion, and cartilage degeneration on magnetic resonance imaging (MRI) scans were also compared. The healing status of the lateral meniscus posterior root was compared using second-look arthroscopy and MRI.

Results:

The duration of surgery was significantly shorter in group S compared with group T (98.3 ± 11.1 vs 127.9 ± 17.5 min; P = .001). At final follow-up, there were no significant differences between the 2 groups in knee functional scores, pivot shift, or grade of cartilage degeneration. Lateral meniscal extrusion was decreased in group S compared with group T (2.41 ± 0.61 vs 1.59 ± 1.35 mm; P = .014). Second-look arthroscopy revealed stable healing in 16 of 18 patients (88.9%) in group S and 10 of 15 patients (66.7%) in group T (P = .38).

Conclusion:

Both the shared ACL bone tunnel and the independent transtibial pullout techniques led to satisfactory clinical outcomes. The shared ACL bone tunnel technique is the simpler of the 2 procedures for combined LMPRT repair with ACLR.

中文翻译：

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共享ACL骨隧道技术修复外侧半月板后根撕裂结合ACL重建

背景：

独立的经胫骨拔出修复是修复外侧半月板后根撕裂（LMPRTs）的常用手术技术。共享前交叉韧带（ACL）骨隧道技术是LMPRT修复结合ACL重建（ACLR）的替代技术，以避免建立额外的骨隧道。

目的：

比较共享 ACL 骨隧道与独立经胫骨拔出技术用于 LMPRT 修复联合 ACLR 的临床结果。

学习规划：

队列研究；证据水平，3。

方法：

2014 年 3 月至 2018 年 2 月期间，共有 48 名患者被诊断为 ACL 损伤并伴有 LMPRT；22例患者接受了独立的经胫骨拔出修复（T组），26例患者接受了共享ACL骨隧道技术（S组）。在超过 2 年的随访中，我们使用 Lysholm、Tegner 和国际膝关节文献委员会评分和枢轴移位测试比较膝关节功能恢复。还比较了磁共振成像 (MRI) 扫描上的横向半月板挤压和软骨退化。使用二次关节镜和 MRI 比较外侧半月板后根的愈合状态。

结果：

S 组的手术时间明显短于 T 组（98.3 ± 11.1 vs 127.9 ± 17.5 min；P = .001）。在最后的随访中，两组在膝关节功能评分、枢轴移位或软骨退化程度方面没有显着差异。与 T 组相比，S 组的横向半月板挤压减少（2.41 ± 0.61 对 1.59 ± 1.35 mm；P = .014）。二次关节镜检查显示，S 组 18 名患者中有 16 名（88.9%）和 T 组 15 名患者中有 10 名（66.7%）愈合稳定（P = .38）。

结论：

共享 ACL 骨隧道和独立的经胫骨拔出技术均产生了令人满意的临床结果。共享 ACL 骨隧道技术是 LMPRT 与 ACLR 联合修复的 2 种程序中更简单的一种。