| Background:Anterior cruciate ligament(ACL)tears are often combined with lateral meniscal posterior root tears(LMPRT).LMPRT further damages the stability of the anterior cruciate ligament(ACL)-deficient knee,and ACL reconstruction alone cannot completely restore the stability of the knee.However,combining LMPRT repair can significantly improve knee stability.The current research on LMPR injury and repair is mostly based on biomechanical experiments,and clinical research is lacking.Objectives:This study was to investigate by patient-reported scores,pivot shift experiment,and magnetic resonance imaging(MRI)images:(1)the effect of ACL tears combined with LMPRT on knee stability;(2)the effect of stability of the ACL-reconstructed knee between LMPRT repair and partial meniscectomy.Methods:A total of 27 patients with ACL tear and LMPR injury were enrolled in this study(group A: ACL reconstruction + LMPR repair,17 patients;group B: ACL reconstruction + LMPR partial meniscectomy,10 patients).At the same time,18 patients who underwent ACL reconstruction for simple ACL tear at the same time were randomly matched as the control group(group C).All patients had at least 12-month follow-up.Lysholm score and International Knee Documentation Committee(IKDC)score were used to assess the knee function of the patients.The physical examination was assessed using the pivot shift test.Anterior tibial subluxation(ATS),lateral meniscal extrusion(LME),Tibial Tubercle-Trochlear Groove(TT-TG)distance,femorotibial rotation(FTR)angle,and the lateral compartment cartilage of the knee were assessed via MRI.The assessment of surgical outcomes was evaluated through intra-group comparison based on various above outcomes before and after surgery or at the last follow-up.The effect of LMPRT combined with ACL tear on knee stability and the difference in knee joint stability between LMPRT repair and LMPR partial meniscectomy in ACL reconstruction is assessed through inter-groups.Results:A total of 45 patients were enrolled in this study,with an average follow-up duration of 14.54±1.88 months.Intragroup comparison: At the last follow-up,Lysholm score,IKDC score,ATS,TT-TG,and FTR improved significantly compared with the preoperative values(P < 0.05).There was a significant difference in the degree of preoperative LME in group A patients compared with the values of the last followup(P<0.05).Intergroup comparison:(1)Preoperatively,there were significant differences in Lysholm score,IKDC score,pivot shift test,ATS,and LME in group C compared with groups A and B(P<0.05),and there was no significant difference in TTTG and FTR in each group(P>0.05).(2)Postoperatively,there was a significant difference in the results of the pivot shift test in group B compared with groups A and C(P<0.05),and there was no significant difference in the results of the pivot shift test between groups A and C(P >0.05).(3)At the last follow-up,there were significant differences in the patient-reported scores and LME in group B compared with groups A and C(P< 0.05).There was a significant difference between group B and group C in ATS,and there was no significant difference between group A and group C in patientreported scores,ATS,and LME(P>0.05).There was no significant difference in TTTG and FTR in each group(P> 0.05).Preoperatively,18 out of 27 patients(66.7%)were diagnosed with LMPRT based on MRI.Conclusions:Combined LMPRT further decreases anterior and rotational stability and the patient-reported scores of the ACL-deficient knee;Compared with LMPR partial meniscectomy,LMPRT repair further improves the anterior and rotational stability of the ACL-reconstructed knee and improves the patient-reported scores;Compared with LMPR partial meniscectomy,LMPRT repair reduces the LME;In certain instances,LMPRT cannot be accurately diagnosed on MRI,careful arthroscopic examination and repair as much as possible are required. |
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