Olgun BİNGÖL, Güzelali ÖZDEMİR, Burak KULAKOĞLU, Ömer Halit KESKİN, Ömer Halit KESKİN, İzzet KORKMAZ

Artroskopik Ön Çapraz Bağ Rekonstrüksiyonu Esnasında Menisküs Yırtıkları Tamir Edilmeli Midir?

Amaç: Bu çalışmanın amacı artroskopik ön çapraz bağ rekonstrüksiyonu uygulanan olgularda eşlik eden menisküs yırtığı nedeniyle parsiyel menisektomi veya menisküs tamiri uygulanan hastaların klinik sonuçlarını karşılaştırmaktır. Gereç ve Yöntem: Artroskopik ön çapraz bağ rekonstrüksiyonu uygulanan hastalarda eşlik eden menisküs yırtığı nedeniyle tedavi edilen 83 olgunun sonuçları retrospektif olarak değerlendirildi. Parsiyel menisektomi uygulanan olgular grup 1 (n=44) ve primer onarım uygulanan olgular grup 2 (n=39) olarak değerlendirildi. Klinik bulguların değerlendirilmesi Tegner aktivite düzeyi skalası ve Lysholm değerlendirme sistemi ile gerçekleştirildi. Bulgular: Preoperatif Lysholm skoru grup 1 ve grup 2’de sırasıyla 61,89±4,36 ve 61,69±4,14 iken, postoperatif olarak 91,80±2,33 ve 95,54±1,97’ye yükseldi (sırasıyla p=0,836, p

Should Meniscus Tears be Repaired During Arthroscopic Anterior Cruciate Ligament Reconstruction?

Objectives: The aim of this present study is to compare the clinical outcomes of patients who underwent partial meniscectomy or meniscus repair due to accompanying meniscal tear in patients who underwent arthroscopic anterior cruciate ligament reconstruction. Materials and Methods: The results of 83 patients treated for concomitant meniscal tear in patients who underwent arthroscopic anterior cruciate ligament reconstruction were evaluated retrospectively. The patients that underwent partial meniscectomy were classified as group 1 (n=44) and the patients that underwent primary repair as group 2 (n=39). Evaluation of clinical outcomes were performed with Tegner activity level scale and Lysholm evaluation system. Results: While the preoperative Lysholm scores were 61.89±4.36 and 61.69±4.14 in groups 1 and 2, respectively, it increased to 91.80±2.33 and 95.54±1.97 postoperatively (respectively, p=0.836, p

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1. Doral MN, Bozkurt M, Atay ÖA, et al. Çapraz bağ yaralanmaları. Türkiye Klin Cerrahi Tıp Bilim Derg. 2006;2:31-34.
2. Fetzer GB, Spindler KP, Amendola A, et al. Potential market for new meniscus repair strategies: evaluation of the MOON cohort. J Knee Surg. 2009;22:180-186.
3. Walter RP, Dhadwal AS, Schranz P, et al. The outcome of all-inside meniscal repair with relation to previous anterior cruciate ligament reconstruction. Knee. 2014;21:1156-1159.
4. Logan CA, Aman ZS, Kemler BR, et al. Influence of Medial Meniscus Bucket- Handle Repair in Setting of Anterior Cruciate Ligament Reconstruction on Tibiofemoral Contact Mechanics: A Biomechanical Study. Arthroscopy. 2019;35:2412-2420.
5. Doral MN, Leblebicioğlu G, Atay A. Ön çapraz bağ yaralanması olan dizlerde menisküs yırtıklarının tedavisine yaklaşım. Acta Orthop Traumatol Turc. 1999;33:426-429.
6. Deledda D, Rosso F, Cottino U, et al. Results of meniscectomy and meniscal repair in anterior cruciate ligament reconstruction. Joints. 2016;3:151- 157.
7. FAIRBANK TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948;30B:664-670.
8. Pengas IP, Assiotis A, Nash W, et al. Total meniscectomy in adolescents: a 40-year follow-up. J Bone Joint Surg Br. 2012;94:1649-1654.
9. Hede A, Larsen E, Sandberg H. The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed. Int Orthop. 1992;16:122-125.
10. Ihn JC, Kim SJ, Park IH. In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy. Int Orthop. 1993;17:214-218.
11. Cristiani R, Parling A, Forssblad M, et al. Meniscus Repair Does Not Result in an Inferior Short-term Outcome Compared With Meniscus Resection: An Analysis of 5,378 Patients With Primary Anterior Cruciate Ligament Reconstruction. Arthroscopy. 2020;36:1145-1153.
12. Jaureguito JW, Elliot JS, Lietner T, et al. The effects of arthroscopic partial lateral meniscectomy in an otherwise normal knee: a retrospective review of functional, clinical, and radiographic results. Arthroscopy. 1995;11:29- 36.
13. Mahiroğulları M, Kuşkucu M, Kiral A, et al. Early results of reconstruction of chronic anterior cruciate ligament ruptures using four-strand hamstring tendon autografts. Acta Orthop Traumatol Turc. 2005;39:224-230.
14. Değirmenci E, Yücel İ, Özturan K. Hamstring tendon otogrefti ile ön çapraz bağ rekonstrüksiyonu. Bakırköy Tıp Derg. 2010;6:29-34.
15. Serbest S, Tosun HB, Yılmaz E. Hamstring Tendon Otogrefti ile Ön Çapraz Bağ Rekonstrüksiyonu. Fırat Tıp Derg. 2011;16:186-189.
16. Corry IS, Webb JM, Clingeleffer AJ, et al. Arthroscopic reconstruction of the anterior cruciate ligament. A comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sports Med. 1999;27:444- 454.
17. Eriksson K, Anderberg P, Hamberg P, et al. A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 2001;83:348-354.
18. Eriksson K, Kindblom LG, Hamberg P, et al. The semitendinosus tendon regenerates after resection: a morphologic and MRI analysis in 6 patients after resection for anterior cruciate ligament reconstruction. Acta Orthop Scand. 2001;72:379-384.
19. Aglietti P, Buzzi R, D’Andria S, et al. Long-term study of anterior cruciate ligament reconstruction for chronic instability using the central one-third patellar tendon and a lateral extraarticular tenodesis. Am J Sports Med. 1992;20:38-45.
20. Clark R, Olsen RE, Larson BJ, et al. Cross-pin femoral fixation: a new technique for hamstring anterior cruciate ligament reconstruction of the knee. Arthroscopy. 1998;14:258-267.
21. Williams RJ 3rd, Hyman J, Petrigliano F, et al. Anterior cruciate ligament reconstruction with a four-strand hamstring tendon autograft. J Bone Joint Surg Am. 2004;86:225-232.
22. Eken G, Misir A, Demirag B, et al. Delayed or neglected meniscus tear repair and meniscectomy in addition to ACL reconstruction have similar clinical outcome. Knee Surg Sports Traumatol Arthrosc. 2020;28:3511-3516.
23. Phillips M, Rönnblad E, Lopez-Rengstig L, et al. Meniscus repair with simultaneous ACL reconstruction demonstrated similar clinical outcomes as isolated ACL repair: a result not seen with meniscus resection. Knee Surg Sports Traumatol Arthrosc. 2018;26:2270-2277.
24. Järvelä T, Kannus P, Järvinen M. Anterior cruciate ligament reconstruction in patients with or without accompanying injuries: A re-examination of subjects 5 to 9 years after reconstruction. Arthroscopy. 2001;17:818-825.