Partial Torn Posterior Horn Of Lateral Meniscus During Anterior Cruciate Ligament Reconstruction Comparative Study Of Clinical Efficacy Of Conservative And Suture Therapy

Objective: To evaluate the effectiveness and accuracy of MRI detection of lateral meniscus tear,and to observe and evaluate the posterior corner tear of the lateral meniscus during anterior cruciate ligament(ACL)reconstruction(the tear length is less than 15 mm,greater than 15 mm and less than 20 mm.Popliteal tendon involved—)Partial suture,partial in situ preservation and simple anterior cruciate ligament(ACL)reconstruction(no meniscus injury)clinical efficacy,postoperative follow-up MRI,secondary knee arthroscopy in some patients,evaluation of the meniscus The healing situation provides a basis and reference for the clinical decision-making for the treatment of lateral meniscus tear in ACL reconstruction.Methods: For 138 patients undergoing ACL reconstruction for acute injury of anterior cruciate ligament caused by acute trauma from 2010 to 2019,all patients had complete preoperative examinations,preoperative nuclear magnetic resonance examinations,and intraoperative verification based on arthroscopy.The accuracy and effectiveness of MRI.During the operation of anterior cruciate ligament(ACL)reconstruction surgery,according to the type of lateral meniscus posterior horn injury,33 cases of group A1 were set to retain the lateral meniscus posterior horn tear(tear(The length of the fissure is less than 15 mm and the popliteal tendon is not involved),the average age is 52 years old,27 cases of the A2 group were sutured with the posterior horn of the lateral meniscus(tear length less than 15 mm,the popliteal tendon was not involved),and 25 cases of the B group were simply ACL reconstructed(No damage to the meniscus),with an average age of 34 years.28 patients in group C1 retained the posterior horn tear of the lateral meniscus in situ(the length of the tear was greater than 15 mm and less than 20 mm,without involving the popliteal tendon),with an average age of 30 years.Twenty-five patients in the C2 group were sutured the posterior horn of the lateral meniscus(the tear length was greater than 15 mm and less than 20 mm,and the popliteal tendon was not involved).After anterior cruciate ligament reconstruction,an average of 11±2 months(8-16 months)were followed up and retrospectively analyzed.Through Lysholm,the International Knee Literature Committee(IKDC)score,patients were assessed for physical examination and functional status before and after surgery.All follow-up patients underwent secondary MRI.Some patients underwent secondary arthroscopy.assessment.Results: The data of 138 patients were used in this experiment,and the average follow-up time was 11±2 months.At the last follow-up,the Lysholm score and the IKDC subjective score of each group were improved compared with those before the operation,with statistical differences(P <0.05).Postoperative clinical results in groups A1,A2,and B,including Lysholm score and International Knee Literature Committee(IKDC)score,were compared between each group,with no statistical difference.Among the patients with C1 and C2 follow-up MRI,the meniscus healing rate displayed by MRI sagittal images was 27(96.43%)and 24(96.00%),respectively,and the difference was not statistically significant.However,including the Lysholm score and the International Knee Literature Committee(IKDC)score,the statistical results of groups C1 and B and C2 are different and have statistical significance(P<0.05);there is no statistical difference between the comparison of groups C2 and B,Eighteen patients underwent secondary arthroscopy.Conclusion:(1)In the reconstruction of the anterior cruciate ligament of the knee,if there is a stable tear of the posterior horn of the lateral meniscus,the length of the tear is less than 15 mm,and the tear does not involve the popliteal tendon,and the stable lateral posterior horn of the lateral meniscus is retained.Anterior cruciate ligament reconstruction has a good clinical effect compared with anterior cruciate ligament reconstruction without meniscus suture and without meniscus injury.(2)In the reconstruction of the anterior cruciate ligament of the knee,if there is a stable tear of the posterior horn of the lateral meniscus,the length of the tear is greater than 15 mm and less than 20 mm,and the tear does not involve the popliteal tendon,and the stable lateral posterior horn of the lateral meniscus is retained.Compared with anterior cruciate ligament reconstruction,compared with anterior cruciate ligament reconstruction without meniscus suturing and no meniscus injury,there were no statistically significant differences in imaging statistics.There were statistical differences between Lysholm score and IKDC score.When ACL reconstruction is performed,the above factors should be taken into consideration when making clinical decisions for partial tearing of the posterior corner of the lateral meniscus.