Clinical efficacy of arthroscopic simultaneous treatment for anterior cruciate ligament injury combined with meniscus bucket-handle tear_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIANG Xuezhen ¹ , TIAN Yuan ² ,  WANG Shaoshan ³ , ZHENG Yueyue ²

1. Shandong University of Traditional Chinese Medicine, Jinan Shandong, 250355, P.R.China;
2. Operation Room, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan Shandong, 250011, P.R.China;
3. Department of Orthopedics, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan Shandong, 250011, P.R.China;

Corresponding?author：

WANG Shaoshan, Email: shaoshan278@sohu.com

Keywords：

Arthroscopy; anterior cruciate ligament; meniscus; bucket-handle tear; ligament reconstruction

DOI：

10.7507/1002-1892.201612066

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the clinical efficacy of arthroscopic simultaneous both anterior cruciate ligament (ACL) reconstruction and suture of the meniscus bucket-handle tear (BHT). Methods Between January 2013 and April 2014, 22 patients (22 knees) with ACL injury and BHT, who accorded with the inclusion criteria, were studied. There were 14 males and 8 females with a mean age of 30.68 years (range, 15-44 years). The left side was involved in 10 cases and the right side in 12 cases. Injury located at the medial meniscus in 14 patients, and at the lateral meniscus in 8 patients. The median of interval from injury to operation was 40 days (range, 9 hours to 4 years). BHT was sutured, and then single bundle reconstruction of ACL was performed under arthroscopy. Results All incisions healed by first intention, and there were no serious complications such as infection, vascular injury, and nerve injury. The patients were followed up for 26.7 months on average (range, 12-42 months). At 6 weeks after operation, one patient had limited motion of the knee, the function was recovered after release under anesthesia; and one patient had joint space tenderness, which was relieved after conservative treatment. The total effective rate was 90.9% (20/22). At last follow-up, the anterior drawer test, Lachman test, and McMurray test were negative in all the cases. The visual analogue scale (VAS), Tegner activity level score, and Lysholm score were significantly improved at 12 months after operation when compared with preoperative scores (P<0.05). At 6-12 months after operation, complete healing was obtained in 7 cases, and partial healing in 11 cases, and nonunion in 4 cases based on MRI evaluation criteria by Crueset al. There was no rupture of reconstruc-tive ligament during follow-up. Conclusion Arthroscopic simultaneous both ACL reconstruction and suture of BHT can improve the symptoms, reduce the risk of re-tear of sutured meniscus effectively, delay degeneration of articular cartilage, and maintain the stability of the knee joint.

Citation： LIANG Xuezhen, TIAN Yuan, WANG Shaoshan, ZHENG Yueyue. Clinical efficacy of arthroscopic simultaneous treatment for anterior cruciate ligament injury combined with meniscus bucket-handle tear. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(5): 547-552. doi: 10.7507/1002-1892.201612066 Copy

1.	?Kluczynski MA, Marzo JM, Bisson LJ. Factors associated with meniscal tears and chondral lesions in patients undergoing anterior cruciate ligament reconstruction: a prospective study. Am J Sports Med, 2013, 41(12): 2759-2765.
2.	Anderson AF, Irrgang JJ, Dunn W, et al. Interobserver reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med, 2011, 39(5): 926-932.
3.	Lim HC, Bae JH, Kim TS, et al. Intra-articular patterns of bucket handle meniscal tears and its relation to reducibility. Clin Orthop Surg, 2012, 4(2): 129-133.
4.	Yoon KH, Park KH. Meniscal repair. Knee Surg Relat Res, 2014, 26(2): 68-76.
5.	張元民, 王國棟, 趙曉偉, 等. 不同半月板修復方式與半月板部分切除術后脛股關節的接觸力學研究. 實用醫學雜志, 2014, 30(18): 2915-2918.
6.	馮華, 姜春巖. 實用骨科運動損傷臨床診斷. 2 版. 北京: 人民軍醫出版社, 2012: 42-50.
7.	Crues JV 3rd, Mink J, Levy TL, et al. Meniscal tears of the knee: accuracy of MR imaging. Radiology, 1987, 164(2): 445-448.
8.	Tucciarone A, Godente L, Fabbrini R, et al. Meniscal tear repaired with Fast-Fix sutures: clinical results in stable versus ACL-deficient knees. Arch Orthop Trauma Surg, 2012, 132(3): 349-356.
9.	Cox CL, Huston LJ, Dunn WR, et al. Are articular cartilage lesions and meniscus tears predictive of IKDC, KOOS, and Marx activity level outcomes after anterior cruciate ligament reconstruction? A 6-year multicenter cohort study. Am J Sports Med, 2014, 42(5): 1058-1067.
10.	馮華, 張輝, 郭鐵能, 等. 膝關節前十字韌帶切斷對內側半月板后角應力的影響. 中華骨科雜志, 2006, 26(7): 476-478.
11.	Feucht MJ, Bigdon S, Bode G, et al. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res, 2015, 10: 34.
12.	Dürselen L, V?gele S, Seitz AM, et al. Anterior knee laxity increases gapping of posterior horn medial meniscal tears. Am J Sports Med, 2011, 39(8): 1749-1755.
13.	王江濤, 劉玉杰, 曲峰, 等. 前交叉韌帶合并半月板損傷同期修復 139 例隨訪報告. 中國骨與關節雜志, 2015, 14(11): 861-864.
14.	李夢遠, 徐雁, 龔熹, 等. 膝關節前交叉韌帶斷裂合并半月板桶柄樣撕裂的臨床治療研究. 中國運動醫學雜志, 2014, 33(5): 385-390.
15.	Krych AJ, Pitts RT, Dajani KA, et al. Surgical repair of meniscal tears with concomitant anterior cruciate ligament reconstruction in patients 18 years and younger. Am J Sports Med, 2010, 38(5): 976-982.
16.	谷紹芳, 陳游. 前交叉韌帶斷裂合并半月板損傷的關節鏡手術治療. 中國現代手術學雜志, 2009, 13(2): 108-110.
17.	閆金明. 關節鏡下修復重建前交叉韌帶合并半月板損傷的臨床效果分析. 中國內鏡雜志, 2016, 22(9): 102-104.
18.	解新剛, 楊惠光, 姜雪鋒, 等. 關節鏡下聯合修補技術治療內側半月板桶柄樣撕裂. 交通醫學, 2009, 23(4): 344-346.
19.	Melton JT, Murray JR, Karim A, et al. Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc, 2011, 19(10): 1729-1734.
20.	O’Shea JJ, Shelbourne KD. Repair of locked bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency. Am J Sports Med, 2003, 31(2): 216-220.
21.	袁帥, 祝云利, 吳宇黎, 等. 關節鏡下內側半月板桶柄樣撕裂聯合縫合 23 例報告. 中國骨與關節雜志, 2015, 4(4): 256-260.
22.	Pierre A, Hulet C, Locker B, et al. Outcome of 95 stable meniscal tears left in place after reconstruction of the anterior cruciate ligament. Rev Chir Orthop Reparatrice Appar Mot, 2001, 87(7): 661-668.
23.	White LM, Schweitzer ME, Weishaupt D, et al. Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. Radiology, 2002, 222(2): 421-429.
24.	鄭卓肇, 余家闊, 尚瑤, 等. 半月板縫合術后: MRI 診斷的價值. 臨床放射學雜志, 2009, 28(1): 81-83.
25.	Sanders TG, Miller MD. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the knee. Am J Sports Med, 2005, 33(1): 131-148.
26.	Toms AP, White LM, Marshall TJ, et al. Imaging the post-operative meniscus. Eur J Radiol, 2005, 54(2): 189-198.
27.	Hantes ME, Zachos VC, Zibis AH, et al. Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol, 2004, 50(3): 231-237.

1. ?Kluczynski MA, Marzo JM, Bisson LJ. Factors associated with meniscal tears and chondral lesions in patients undergoing anterior cruciate ligament reconstruction: a prospective study. Am J Sports Med, 2013, 41(12): 2759-2765.
2. Anderson AF, Irrgang JJ, Dunn W, et al. Interobserver reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med, 2011, 39(5): 926-932.
3. Lim HC, Bae JH, Kim TS, et al. Intra-articular patterns of bucket handle meniscal tears and its relation to reducibility. Clin Orthop Surg, 2012, 4(2): 129-133.
4. Yoon KH, Park KH. Meniscal repair. Knee Surg Relat Res, 2014, 26(2): 68-76.
5. 張元民, 王國棟, 趙曉偉, 等. 不同半月板修復方式與半月板部分切除術后脛股關節的接觸力學研究. 實用醫學雜志, 2014, 30(18): 2915-2918.
6. 馮華, 姜春巖. 實用骨科運動損傷臨床診斷. 2 版. 北京: 人民軍醫出版社, 2012: 42-50.
7. Crues JV 3rd, Mink J, Levy TL, et al. Meniscal tears of the knee: accuracy of MR imaging. Radiology, 1987, 164(2): 445-448.
8. Tucciarone A, Godente L, Fabbrini R, et al. Meniscal tear repaired with Fast-Fix sutures: clinical results in stable versus ACL-deficient knees. Arch Orthop Trauma Surg, 2012, 132(3): 349-356.
9. Cox CL, Huston LJ, Dunn WR, et al. Are articular cartilage lesions and meniscus tears predictive of IKDC, KOOS, and Marx activity level outcomes after anterior cruciate ligament reconstruction? A 6-year multicenter cohort study. Am J Sports Med, 2014, 42(5): 1058-1067.
10. 馮華, 張輝, 郭鐵能, 等. 膝關節前十字韌帶切斷對內側半月板后角應力的影響. 中華骨科雜志, 2006, 26(7): 476-478.
11. Feucht MJ, Bigdon S, Bode G, et al. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res, 2015, 10: 34.
12. Dürselen L, V?gele S, Seitz AM, et al. Anterior knee laxity increases gapping of posterior horn medial meniscal tears. Am J Sports Med, 2011, 39(8): 1749-1755.
13. 王江濤, 劉玉杰, 曲峰, 等. 前交叉韌帶合并半月板損傷同期修復 139 例隨訪報告. 中國骨與關節雜志, 2015, 14(11): 861-864.
14. 李夢遠, 徐雁, 龔熹, 等. 膝關節前交叉韌帶斷裂合并半月板桶柄樣撕裂的臨床治療研究. 中國運動醫學雜志, 2014, 33(5): 385-390.
15. Krych AJ, Pitts RT, Dajani KA, et al. Surgical repair of meniscal tears with concomitant anterior cruciate ligament reconstruction in patients 18 years and younger. Am J Sports Med, 2010, 38(5): 976-982.
16. 谷紹芳, 陳游. 前交叉韌帶斷裂合并半月板損傷的關節鏡手術治療. 中國現代手術學雜志, 2009, 13(2): 108-110.
17. 閆金明. 關節鏡下修復重建前交叉韌帶合并半月板損傷的臨床效果分析. 中國內鏡雜志, 2016, 22(9): 102-104.
18. 解新剛, 楊惠光, 姜雪鋒, 等. 關節鏡下聯合修補技術治療內側半月板桶柄樣撕裂. 交通醫學, 2009, 23(4): 344-346.
19. Melton JT, Murray JR, Karim A, et al. Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc, 2011, 19(10): 1729-1734.
20. O’Shea JJ, Shelbourne KD. Repair of locked bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency. Am J Sports Med, 2003, 31(2): 216-220.
21. 袁帥, 祝云利, 吳宇黎, 等. 關節鏡下內側半月板桶柄樣撕裂聯合縫合 23 例報告. 中國骨與關節雜志, 2015, 4(4): 256-260.
22. Pierre A, Hulet C, Locker B, et al. Outcome of 95 stable meniscal tears left in place after reconstruction of the anterior cruciate ligament. Rev Chir Orthop Reparatrice Appar Mot, 2001, 87(7): 661-668.
23. White LM, Schweitzer ME, Weishaupt D, et al. Diagnosis of recurrent meniscal tears: prospective evaluation of conventional MR imaging, indirect MR arthrography, and direct MR arthrography. Radiology, 2002, 222(2): 421-429.
24. 鄭卓肇, 余家闊, 尚瑤, 等. 半月板縫合術后: MRI 診斷的價值. 臨床放射學雜志, 2009, 28(1): 81-83.
25. Sanders TG, Miller MD. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the knee. Am J Sports Med, 2005, 33(1): 131-148.
26. Toms AP, White LM, Marshall TJ, et al. Imaging the post-operative meniscus. Eur J Radiol, 2005, 54(2): 189-198.
27. Hantes ME, Zachos VC, Zibis AH, et al. Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol, 2004, 50(3): 231-237.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical efficacy of arthroscopic simultaneous treatment for anterior cruciate ligament injury combined with meniscus bucket-handle tear

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content