侧－侧修复术治疗放射状外侧半月板后根部撕裂

doi:10.3877/cma.j.issn.1674-134X.2025.05.015

中华关节外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (05) : 637 -641. doi: 10.3877/cma.j.issn.1674-134X.2025.05.015

临床经验

侧－侧修复术治疗放射状外侧半月板后根部撕裂

张志勇¹, 王俊义², 韩长旭³, 孟晨阳³, 刘明², 韩娇⁴^,^†(

)

¹010030　呼和浩特，内蒙古医科大学第二附属医院影像科
²010030　呼和浩特，内蒙古医科大学
³010030　呼和浩特，内蒙古医科大学第二附属医院运动医学中心
⁴110000　沈阳，北部战区总医院（沈河院区）放射治疗科

收稿日期:2025-03-10 出版日期:2025-10-01
通信作者: 韩娇
基金资助:
内蒙古自治区公立医院高水平临床专科发展科技项目(2023SGGZ140); 内蒙古自治区自然科学基金项目(2022MS08015); 内蒙古自治区卫生健康科技计划项目(202201344)

Side-to-side repair surgery for radial lateral meniscus posterior root tear

Zhiyong Zhang¹, Junyi Wang², Changxu Han³, Chenyang Meng³, Ming Liu², Jiao Han⁴^,^†()

¹Department of Imaging, Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, China
²Inner Mongolia Medical University, Hohhot 010030, China
³Sports Medicine Center of Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, China
⁴Radiotherapy Department of Northern Theater Command General Hospital (Shenhe District), Shenyang 110000, China

Received:2025-03-10 Published:2025-10-01
Corresponding author: Jiao Han

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引用本文：

张志勇, 王俊义, 韩长旭, 孟晨阳, 刘明, 韩娇. 侧－侧修复术治疗放射状外侧半月板后根部撕裂[J/OL]. 中华关节外科杂志(电子版), 2025, 19(05): 637-641.

Zhiyong Zhang, Junyi Wang, Changxu Han, Chenyang Meng, Ming Liu, Jiao Han. Side-to-side repair surgery for radial lateral meniscus posterior root tear[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2025, 19(05): 637-641.

目的

验证关节镜下侧－侧修复术治疗放射状外侧半月板后根部撕裂（PLMRTs）的临床疗效。

方法

回顾性分析2019年1月到2021年1月期间在内蒙古医科大学第二附属医院运动医学中心因外伤导致的外侧半月板后根部放射状撕裂而采用关节镜下侧－侧缝合的27例患者资料。记录患者术前、末次随访时国际膝关节文献委员会（IKDC）主观评分、Lysholm和Tegner评分和并发症情况，采用配对样本t检验分析术前与术后评分差异。

结果

27例患者符合纳入标准，男19例，女8例，平均年龄（26±8）岁；受伤至手术平均时间（15±11）d；平均随访（16±4）月。随访期间无患者出现半月板再撕裂、关节间隙压痛或McMurray试验阳性。术后末次随访IKDC评分（93.1±2.3）、Lysholm评分（96.2±3.0）、Tegner评分（5.9±0.6），显著高于术前的（43.4±6.3）、（55.3±4.6）、（2.5±0.7），差异有统计学意义（t=40.83、45.96、26.30，均为P<0.05）。

结论

关节镜下侧－侧修复治疗PLMRTs手术，可显著改善患者的主观和客观功能，临床疗效显著。

关键词: 半月板, 胫骨半月板损伤, 关节镜术

Objective

To determine the clinical effect after side-to-side repair for radial posterior lateral meniscus root tears (PLMRTs) under arthroscope.

Methods

A retrospective analysis was conducted on the data of 27 patients who suffered from posterior root radiating tears of the lateral meniscus due to trauma and underwent arthroscopic lateral-lateral suturing at the Sports Medicine Center of Second Affiliated Hospital Inner Mongolia Medical University from January 2019 to January 2021.The preoperative and last follow-up International Knee Documentation Committee (IKDC) subjective scores, Lysholm and Tegner scores, and complications were recorded. Paired sample t-tests were used to analyze the differences in scores before and after surgery.

Results

All 27 patients met the inclusion criteria and were followed up for an average of (16±4) months. There were 19 males and 8 females, with an average age of (26±8) years, and the average time from injury to surgery was (15±11) days. During the follow-up period, no patient experienced re-tear of the meniscus, joint space tenderness, or positive McMurray test. The IKDC score (93.1±2.3), Lysholm score (96.2±3.0), and Tegner score (5.9±0.6) at the last follow-up were significantly higher than those before surgery (43.4±6.3), (55.3±4.6), and (2.5±0.7), with statistically significant differences (t=40.83, 45.96, and 26.30, respectively; P=0.01).

Conclusion

Arthroscopic lateral-lateral repair for PLMRTs can significantly improve the subjective and objective functions of patients, and the clinical efficacy is remarkable. The passive voice in the past tense is used for expression.

Key words: Meniscus, Tibial meniscus injuries, Arthroscopy

图1 关节镜下外侧半月板后根撕裂修复操作过程。图A为外侧半月板后根撕裂边缘；图B为外侧半月板后根撕裂边缘新鲜化后；图C为Fast-Fix360缝合器与撕裂内侧进针点；图D为Fast-Fix360缝合器与撕裂外侧进针点（距离撕裂边缘约5 cm处）；图F为1~3针缝合后固定效果

Figure 1 Process of repairing the posterior root tear of the lateral meniscus under arthroscope. A is the edge of the posterior root tear of the lateral meniscus; B is the freshened edge of the posterior root tear of the lateral meniscus; C is the Fast-Fix360 suture device and the puncture point on the inner side of the tear; D is the Fast-Fix360 suture device and the puncture point on the outer side of the tear (about 5 cm away from the tear edge); F shows the fixation effect after one to three stitches

图2 外侧半月板后根撕裂修复手术前后膝关节MRI。图A为术前MRI（矢状位）显示外侧半月板后根撕裂（箭头示撕裂处高信号）；图B为术后12个月MRI显示撕裂处信号连续，半月板结构修复良好

Figure 2 MRI images of knee before and after repair surgery for posterior root tear of the lateral meniscus. A is MRI (sagittal view) before surgey showing a posterior root tear of the lateral meniscus (arrow indicates the high signal at the tear site); B is MRI at 12 months after surgery, showing continuous signal at the tear site and good repair of the meniscus structure

表1 修复手术前后功能对比

Table 1 Comparison of functional prognosis before and after the repair surgery

时间Time	IKDC评分IKDC score	Lysholm评分Lysholm score	Tegner评分Tegner score
术前Before operation	43.4±6.3	55.3±4.6	2.5±0.7
术后3个月Three months after operation	49.4±3.7	87.1±2.2	96.2±2.9
术后末次随访^*Last follow up	93.1±2.3	2.5±0.7	5.9±0.6
t值^*	40.83	45.96	26.30
P值	<0.05	<0.05	<0.05

表1 修复手术前后功能对比

Table 1 Comparison of functional prognosis before and after the repair surgery

时间Time	IKDC评分IKDC score	Lysholm评分Lysholm score	Tegner评分Tegner score
术前Before operation	43.4±6.3	55.3±4.6	2.5±0.7
术后3个月Three months after operation	49.4±3.7	87.1±2.2	96.2±2.9
术后末次随访^*Last follow up	93.1±2.3	2.5±0.7	5.9±0.6
t值^*	40.83	45.96	26.30
P值	<0.05	<0.05	<0.05

图3 经胫骨拉出修复外侧半月板后根示意图

Figure 3 Diagram of the pull-out and repair of the posterior root of the lateral meniscus through the tibia

图4 侧－侧修复技术恢复PLMRTs（外侧半月板后根部撕裂）环形应力示意图

Figure 4 Schematic diagram of side to side repair technique for restoring the annular stress of PLMRTs

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Side-to-side repair surgery for radial lateral meniscus posterior root tear

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Side-to-side repair surgery for radial lateral meniscus posterior root tear