Study on clinical characteristics and surgical methods of bucket-handle meniscal tears / 中国修复重建外科杂志

OBJECTIVE@#To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment.@*METHODS@#The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded.@*RESULTS@#Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation ( P<0.05), while Tegner score significantly decreased ( P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation ( P<0.05).@*CONCLUSION@#BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.

Clinical Results of the Accelerated Rehabilitation Program after Meniscal Repair using the RapidLoc Device / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the clinical results of the accelerated rehabilitation program after performing meniscal repair using the RapidLoc device, and we wanted to investigate the incidence of complications related to using the RapidLoc device together with the accelerated rehabilitation program. MATERIALS AND METHODS: We performed a retrospective review of a consecutive series of meniscal repairs that were done by single surgeon with using the RapidLoc meniscal repair device. An accelerated postoperative rehabilitation program followed, and this was independent of whether anterior cruciate ligament (ACL) surgery was also performed. The Lysholm and IKDC (International Knee Documentation Committee) activity scores, the clinical examination findings and the adverse events were recorded for all the patients. In addition, using Barrett's criteria, a repaired meniscus was considered healed if there was no joint line tenderness, effusion or a negative McMurray's test at the latest follow-up. RESULTS: At follow-up, the mean IKDC activity score was 3.38 (1.75 preoperatively), the Lysholm score was 91.8 (48.7 preoperatively). Clinical success occurred for 30 repairs (93.7%) at the time of the last follow-up. Two patient had tenderness on joint line palpation and intermittent effusion, so theses repair were considered failure according to our criteria. There was no specific complication related to the RapidLoc device. CONCLUSION: Our results show that accelerated rehabilitation program after arthroscopic meniscal repair with using the RapidLoc device provided a high rate of clinical meniscus healing and this appeared to be safe and effective.

Two Posteromedial Portal Technique of All-Inside Meniscus Repair for Posterior Horn Tear of Medial Meniscus

No abstract available.