Ishimura M, Tamai S, Fujisawa Y
Department of Orthopaedic Surgery, Nara Medical University, Japan.
Arthroscopy. 1991;7(2):177-81. doi: 10.1016/0749-8063(91)90106-8.
Since 1984 we have arthroscopically repaired 40 meniscal tears in 32 patients using fibrin glue in our operative technique. This technique was reported initially in 1985 (Ishimura M, Samma M, Habata T, Fujisawa Y. The use of fibrin glue for fresh knee injury. Cent Jpn Orthop Traumat 1985; 28:1404-8), with a more detailed study published in 1987 [Ishimura M, Samma M, Fujisawa Y, et al. Arthroscopic repair of the meniscus tears with fibrin glue. Arthroscopy (Jpn) 1987;12:31-6]. During the follow-up period, which ranged from 10 months to 6 years and 7 months (mean: 3 years and 8 months), only two patients complained of meniscal symptoms and underwent arthroscopic partial meniscectomy. Twenty patients with 25 repairs underwent repeat arthroscopy at an average of 5.7 months (range: 2 months-1 year and 2 months) after the initial repair. Twenty repairs were rated as good, four as fair, and one as poor by arthroscopic evaluation criteria. At present, the most appropriate use of this arthroscopic meniscal gluing technique is in tears in the posterior segment, which are difficult to suture without arthrotomy. Even a long tear with a stable reduced position can be expected to show good healing. When reduction of the tear is not stable, additional sutures should be used.
自1984年以来，我们采用纤维蛋白胶辅助关节镜手术技术，为32例患者修复了40处半月板撕裂伤。该技术最初于1985年被报道（石村正、萨摩正、羽场彻、藤泽洋。纤维蛋白胶在新鲜膝关节损伤中的应用。日本中部矫形创伤杂志1985；28：1404 - 8），1987年发表了更详细的研究[石村正、萨摩正、藤泽洋等。纤维蛋白胶辅助关节镜下半月板撕裂修复术。关节镜（日本）1987；12：31 - 6]。在10个月至6年零7个月（平均：3年零8个月）的随访期内，只有2例患者出现半月板症状并接受了关节镜下部分半月板切除术。20例患者接受了25处修复手术，在初次修复后平均5.7个月（范围：2个月至1年零2个月）接受了再次关节镜检查。根据关节镜评估标准，20处修复被评为良好，4处为中等，1处为差。目前，这种关节镜下半月板粘贴技术最适用于后段撕裂伤，这类损伤在不进行切开手术的情况下难以缝合。即使是撕裂口长但复位稳定的情况，也有望实现良好愈合。当撕裂口复位不稳定时，应使用额外的缝线。
