A Comparative Study Of Trans-tibial Tunnel Pulling Wire Fixation Method And Total Internal Suture Method In The Treatment Of Posterior Root Injury Of Lateral Meniscus

Objective:To compare and analyze the clinical effects of tibial tunnel cable fixation and total meniscus suture in the treatment of anterior cruciate ligament injury combined with lateral meniscus posterior root tear.Methods:A total of 92 patients with anterior cruciate ligament injury combined with lateral meniscus posterior root tear admitted to our hospital from January 2016 to December 2021 were selected according to the attrition standard for the study.The patients were divided into four groups according to the treatment methods: observation group(49 cases)underwent arthroscopic tibial tunnel cable fixation operation,and control group(43 cases)underwent arthroscopic total internal suture operation.After grouping,According to perioperative observation indexes and complications,knee functional recovery indexes(knee motion,VAS score,IKDC score,Lysholm score,Tegner score)Score),imaging observation indicators(absolute distance of meniscus compression,overall meniscus width and relative percentage of meniscus compression before and at the last follow-up),and observation of therapeutic effect under different Petersen classification were statistically compared and analyzed,and clinical efficacy of the two surgical methods were discussed.Results:1.General information: There was no statistical significance in age,gender,BMI,injured side,classification,knee range of motion,VAS frequency,IKDC score,Lysholm score and Tegner score between the two groups(P>0.05).2.Perioperative observation indexes: The operation duration of the observation group was longer than that of the control group(P<0.05),and there were no statistical differences in the amount of blood loss,bed time and hospital stay between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).3.Knee functional recovery indicators: the knee flexion of the observation group at 3 and6 months after surgery was significantly better than that of the control group(P<0.05),but there was no statistical difference between the two groups at 9 months and 12 months after surgery(P>0.05);There was no significant difference in the knee elongation between the two groups at each follow-up time point(P>0.05),but the overall knee motion of the two groups increased with the increase of time.There were no significant differences in VAS score and Tegner score between the two groups at each follow-up time point(P>0.05),but the two scores of the two groups increased with the increase of time.IKDC and Lysholm scores of the observation group were better than those of the control group at 3 and 6 months after surgery(P<0.05),but there was no statistical difference between the two groups at 9 and 12 months after surgery(P>0.05),but the two scores of the two groups increased with the increase of time.4.Imaging observation indicators: there was no statistical difference in the overall meniscus width between the two groups before and 12 months after surgery(P>0.05).The absolute distance of meniscus compression at 12 months after surgery was less than that before surgery(P<0.05).The absolute distance and percentage of meniscus extrusion in the observation group were better than those in the control group 12 months after surgery,and the results were statistically different(P<0.05).5.Observation of therapeutic effect under different classification: The transverse tear or rupture of posterior meniscus was better treated by tibial tunnel pedicle fixation under arthroscopy(West Type Ⅲ),and the results were statistically different(P<0.05).However,for simple injuries within 1cm of posterior meniscus root insertion(West Type Ⅱ),There was no significant difference between this method and total internal suture under arthroscopy(P>0.05).Conclusion:The effect of arthroscopic tibial tunnel cable fixation is accurate.This method can accelerate the recovery speed within 6 months after LMPRT,and improve the effect of posterior meniscus root repair.Arthroscopic tibial tunnel pedicle fixation is better for the treatment of complex radial tears in the posterior meniscus root(West Type Ⅲ),but for simple longitudinal and radial cracks within 1cm of the posterior meniscus root insertion(West Type Ⅱ),there is no significant difference in the efficacy of arthroscopic total internal suture.