Background

Transtibial pullout repair yields beneficial clinical outcomes in patients with medial meniscus (MM) posterior root tear. However, the relationship between repaired meniscal root healing status and postoperative clinical outcomes remains unclear. We aimed to evaluate changes in articular cartilage damage and clinical scores after pullout repair using two simple stitches (TSS).

Methods

Thirty-three patients who underwent pullout repair using TSS were assessed. Healing status was assessed by a semi-quantitative second-look arthroscopic scoring system comprising three evaluation criteria (width of bridging tissues, stability of the repaired root, and synovial coverage), 1 year postoperatively. MM medial extrusion (MMME) and cartilage damage were assessed preoperatively and 1 year postoperatively. The medial compartment was divided into 8 zones (A-H) for comparison of preoperative and 1-year postoperative cartilage damage. Clinical outcomes were evaluated using the Knee Injury and Osteoarthritis Outcome score, Lysholm score, International Knee Documentation Committee scores, and visual analogue scale pain score.

Results

Although cartilage damage did not aggravate significantly in most medial compartment areas, MMME progressed at 1 year postoperatively. No statistical differences were observed in cartilage damage between the central-to-medial area of the medial femoral condyle and the medial tibial plateau area at 1 year postoperatively. Regarding semi-quantitative healing scores, the stability score was significantly correlated with the International Cartilage Repair Society grade at 1 year postoperatively. All 1-year and 2-year clinical scores significantly improved compared with the preoperative scores.

Conclusion

Regarding TSS repair, stability of repaired meniscal root negatively correlated with cartilage damage in the medial compartment loading area. All 1-year and 2-year clinical scores significantly improved than those of the preoperative scores. Achieving MM stability is crucial for suppressing cartilage degeneration.

Level of evidence

IV case series study.

中文翻译：

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修复半月板根部的稳定性会影响内侧半月板后根部修复术后的软骨状态

背景

经胫骨拔出修复术对内侧半月板 (MM) 后根撕裂患者产生有益的临床结果。然而，修复后的半月板根部愈合状态与术后临床结果之间的关系仍不清楚。我们的目的是评估使用两种简单缝合（TSS）进行拔出修复后关节软骨损伤和临床评分的变化。

方法

对 33 名使用 TSS 进行拔出修复的患者进行了评估。术后1年，通过半定量二次关节镜评分系统评估愈合状态，该系统包括三个评估标准（桥接组织的宽度、修复根部的稳定性和滑膜覆盖率）。术前和术后 1 年评估 MM 内侧挤压 (MMME) 和软骨损伤。将内侧间室分为8个区域（AH），用于比较术前和术后1年的软骨损伤。使用膝关节损伤和骨关节炎结果评分、Lysholm 评分、国际膝关节文献委员会评分和视觉模拟量表疼痛评分来评估临床结果。

结果

尽管大多数内侧间室区域的软骨损伤并未明显加重，但 MMME 在术后 1 年出现进展。术后1年股骨内侧髁中央区域与胫骨平台区域软骨损伤情况无统计学差异。关于半定量愈合评分，稳定性评分与术后1年国际软骨修复协会等级显着相关。所有1年和2年临床评分均较术前显着改善。

结论

关于 TSS 修复，修复后的半月板根部的稳定性与内侧间室负载区域的软骨损伤呈负相关。所有1年和2年临床评分均较术前显着改善。实现 MM 稳定性对于抑制软骨退化至关重要。

证据级别

IV 案例系列研究。