评估膝关节前交叉韧带损伤伴外侧半月板后角撕裂不同撕裂长度修复或不修复的术后临床疗效及半月板愈合情况，为治疗膝关节前交叉韧带损伤伴外侧半月板后角撕裂临床决策提供依据和参考。

回顾性分析2010年至2019年于青岛大学附属医院运动医学科收治的113例膝关节前交叉韧带损伤伴外侧半月板后角撕裂的患者。纳入标准：前交叉韧带损伤伴外侧半月板后角撕裂；术中测量半月板撕裂边缘距离滑膜缘5 mm以内；术后随访时间12个月。排除标准：膝关节多发韧带损伤；内侧半月板损伤；伴膝关节骨折等；外伤后6个月以上。根据外侧半月板后角撕裂长度及是否缝合修复，分为两个大组：小撕裂组，即外侧半月板后角撕裂长度小于15 mm，未累及腘肌腱(小撕裂1组33例未缝合修复；小撕裂2组27例行全内缝合)；中度撕裂组，即外侧半月板后角撕裂长度大于15 mm小于20 mm，未累及腘肌腱(中度1组28例未缝合修复，中度2组25例行全内缝合)。术前及术后12个月随访时记录患者Lysholm评分、国际膝关节文献委员会(IKDC)评分、影像学MRI检查。采用重复测量方差分析、卡方检验及直方图形式等对上述资料进行对比分析。

所有患者均获得随访，末次随访临床功能评分均较术前有所提高。对于外侧半月板撕裂长度小于15 mm者，采取缝合后修复或原位保留两种治疗方式其术后的术后的Lysholm功能评分和IKDC评分差异无统计学意义(F＝0.49、2.21，均为P>0.05)；而对于外侧半月板撕裂长度15~20 mm的患者，缝合修复术后Lysholm功能评分和IKDC评分对比未缝合修复患者有明显提高(F＝189.21、41.08，均为P<0.05)。MRI复查结果显示小撕裂组患者全部愈合，中度组两个亚组愈合率分别为96.4%和96.0%，差异无统计学意义(χ²＝0.94，P>0.05)。

对于膝关节前交叉韧带损伤伴外侧半月板后角撕裂的患者，若外侧半月板后角撕裂未累及腘肌腱且撕裂长度小于15 mm，不修复撕裂的外侧半月板后角亦可愈合，且可达到与半月板缝合后及单纯ACL重建后的临床疗效；若外侧半月板后角撕裂未累及腘肌腱且撕裂长度大于15 mm小于20 mm，更推荐行外侧半月板后角撕裂缝合修复。

To evaluate the postoperative clinical efficacy and meniscus healing of knee anterior cruciate ligament(ACL) injury with lateral meniscus posterior horn tear by different treatment methods with different tear lengths, and to provide basis and reference for clinical decision-making of knee ACL injury with lateral meniscus posterior horn tear.

A retrospective analysis was carried out on 113 patients with ACL injury accompanied with lateral meniscus posterior angle tear who were admitted to the Sports Medicine Department of Qingdao University Affiliated Hospital from 2010 to 2019. Inclusion criteria: ACL injury with lateral meniscus posterior angle tear; the distance between the tear edge of the meniscus and the synovial margin was within 5 mm during surgery; the postoperative follow-up time was 12 months. Exclusion criteria: multiple ligament injuries in the knee joint; inner meniscus injury; accompanying knee joint fractures; the duration was more than six months after trauma. According to the posterior horn tear length of the lateral meniscus and whether it had been sutured for repair, the patients were divided into two groups: the small tear group in which the posterior horn tear length was less than 15 mm and no popliteal tendon involved (33 cases were not sutured for repair in the small tear group A; 27 cases were fully sutured in the small tear group B); the moderate tear group in which the posterior horn tear length was larger than 15 mm but less than 20 mm, and no popliteal tendon involved (28 cases were not sutured for repair in the moderate tear group A, while 25 cases were fully sutured in the moderate tear group B). Lysholm score, International Knee Joint Documentation Committee (IKDC) score, and imaging MRI examination before surgery and at 12 months follow-up after surgery were recorded. The data were analyzed by repeated measurement analysis of variance, chi square test, and histogram format.

All the patients were followed up and showed improvement in their clinical functional scores at the last follow-up compared to the scores before surgery. For patients with lateral meniscus tear length less than 15 mm, there was no statistically significant difference in postoperative Lysholm functional score and IKDC score between suture repair and non-suture repair (F=0.49, 2.21, all P>0.05). For lateral meniscus tear-length of 15 to 20 mm, the postoperative Lysholm functional score and IKDC score of the suture repair group were significantly improved compared to the non-suture repair group (F=189.21, 41.08, all P <0.05). MRI results at follow-up showed that all patients in small tear group achieved satisfactory healing; the healing rates of the two subgroups in the moderate group was 96.4% and 96.0% respectively, which showed no statistically significant difference(χ²=0.94, P>0.05).

For patients with ACL injury accompanied with posterior horn tear of lateral meniscus, if the popliteal tendon is not involved and the tear length is less than 15 mm, the posterior horn of lateral meniscus can be healed without repair, which may achieve the equal clinical efficacy as suture repair of meniscus and simple ACL reconstruction. If the popliteal tendon is not involved and the tear length is larger than 15 mm and less than 20 mm, suture repair of the posterior horn of the lateral meniscus tear is stronly recommended.