Efficacy of Arthroscopic Treatment for Concurrent Medial Meniscus Posterior Horn and Lateral Meniscus Anterior Horn Injury: A Retrospective Single Center Study

Autor: Jun‐cheng Cui, Wente Wu, Pengfei Lei, Zhiwei Chen, Long Xin
Rok vydání: 2020
Předmět:
Zdroj: Orthopaedic Surgery
Orthopaedic Surgery, Vol 13, Iss 1, Pp 45-52 (2021)
ISSN: 1757-7861
1757-7853
Popis: Objective To investigate the effectiveness of arthroscopic surgery for combined tears of the posterior horn of the medial meniscus (PHMM) and the anterior horn of the lateral meniscus (AHLM). Methods Between September 2009 and December 2013, a retrospective investigation was performed on 48 patients (48 knees) with combined tears of PHMM and AHLM who underwent arthroscopic surgery. All patients underwent magnetic resonance imaging (MRI) diagnosis in the outpatient department. After admission, other basic examinations were performed. PHMM was treated with partial meniscectomy and AHLM was treated with external–internal suture or partial meniscectomy. Curative effect was evaluated according to Lysholm score and IKDC score. The differences of the functions as well as Lysholm and IKDC scores pre‐ and postoperatively were compared, while the diagnostic accuracy of MRI and arthroscopy for PHMM and AHLM were compared. Results Seven patients with combined tears of PHMM and AHLM were misdiagnosed during MRI examination when arthroscopy was used as the gold standard. All patients were followed up for an average of 34.58 months (range 10–52 months) and all incisions healed by first intention with no obvious complication. The preoperative and postoperative Lysholm scores were 47.22 ± 2.77 and 87.36 ± 5.45, respectively. The IKDC scores are 54.73 ± 4.65 preoperatively and 89.62 ± 3.71 postoperatively. The positive rates of the diagnosis through MRI and arthroscopic surgery is 85.42% and 100%, respectively. At the last follow‐up, the patients had no pain, weakness, and instability, and tenderness in medial and lateral joint space disappeared. Mcmurray test was weakly positive in four patients. Excellent outcome was achieved in 39 cases, and a good outcome was achieved in five cases; the good to excellent rate was 91.67%. Conclusion MRI examination of combined tears of PHMM and AHLM may result in misdiagnosis. Arthroscopic primary repair seemed to be an effective surgical option for treatment of combined tears of PHMM and AHLM.
Schematic diagram of arthroscopy of meniscus injury following surgery; (A) The anatomic structure of the knee; (B) AHLM and PHMM injuries of the meniscus; (C) Description of the performed meniscus injury with suture anterior horn of the lateral meniscus; (D) Description of the performed meniscus injury with removal of the incomplete bacterial horn of the medial meniscus.
Databáze: OpenAIRE
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