Comparison of Clinical and Radiologic Results Between Partial Meniscectomy and Refixation of Medial Meniscus Posterior Root Tears: A Minimum 5-Year Follow-up

被引:169
作者
Chung, Kyu Sung [1 ]
Ha, Jeong Ku [2 ]
Yeom, Cheol Hyun [2 ]
Ra, Ho Jong [3 ]
Jang, Ho Su [2 ]
Choi, Seung Hyuk [2 ]
Kim, Jin Goo [4 ]
机构
[1] KEPCO Med Ctr, Dept Orthoped Surg, Seoul, South Korea
[2] Inje Univ, Coll Med, Seoul Paik Hosp, Dept Orthoped Surg, Seoul, South Korea
[3] Univ Ulsan, Coll Med, Gangneung Asan Hosp, Dept Orthoped Surg, Kangnung, South Korea
[4] KonKuk Univ, Med Ctr, Dept Orthoped Surg, Seoul, South Korea
关键词
PULL-OUT REPAIR; 2ND-LOOK ARTHROSCOPIC FINDINGS; BIOMECHANICAL CONSEQUENCES; SUTURE ANCHOR; RADIAL TEARS; HORN; MECHANICS;
D O I
10.1016/j.arthro.2015.03.035
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To compare the clinical and radiologic results of partial meniscectomy with those of refixation in patients with medial meniscus posterior root tears (MMPRTs) at a minimum 5-year follow-up. Methods: Between 2005 and 2009, patients with MMPRTs who had been followed up for at least 5 years after a partial meniscectomy (group M, n = 20) or pullout repair (group R, n = 37) were recruited. The mean follow-up duration was 67.5 months in group M and 72.0 months in group R. Clinical assessments, including the Lysholm score and International Knee Documentation Committee (IKDC) Subjective Knee Form score, and radiographic assessments, including the Kellgren-Lawrence (K-L) grade and medial joint space width, were evaluated preoperatively and at final follow-up. We compared the preoperative results with the final results in each group, and we compared the final results of groups M and R. Five-year survival rates were also evaluated. Results: The mean Lysholm score (P = .039) and IKDC score (P = .037) improved significantly. However, the width of the medial joint space (P < .001) and K-L grade (P < .001) worsened significantly in both groups. When we compared the final results, group R had significantly better Lysholm scores (P = .002) and IKDC scores (P < .001) than group M. Group R showed less K-L grade progression (P = .005) and less medial joint space narrowing (P < .001) than group M. The rate of conversion to total knee arthroplasty was 35% in group M, whereas there was no conversion to total knee arthroplasty in group R. The 5-year survival rates in groups M and R were 75% and 100%, respectively (P < .001). Conclusions: For MMPRTs, refixation was more effective than partial meniscectomy in terms of the clinical and radiologic outcomes and survival for at least 5 years' follow-up. Refixation slowed the progression of arthritic changes compared with partial meniscectomy, although it did not prevent the progression of arthrosis completely.
引用
收藏
页码:1941 / 1950
页数:10
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