Istituto Chirurgico Ortopedico Traumatologico, Latina, Italy.
Arch Orthop Trauma Surg. 2012 Mar;132(3):349-56. doi: 10.1007/s00402-011-1391-5. Epub 2011 Sep 18.
The aim of this prospective study was to analyze the results of meniscal tears repaired with Fast-Fix All-inside suture in stable versus anterior cruciate ligament (ACL)-deficient knees.
Forty patients, everybody professional players, all underwent arthroscopic surgery, were divided into two groups and followed-up for at least 24 months. Group A (stable knee affected with isolated meniscal tears) consisted of 20 patients treated exclusively with Fast-Fix suture. Group B (ACL-deficient knees affected with meniscal tears) consisted of 20 patients in which we performed a Fast-Fix suture with concurrent ACL reconstruction (hamstring duplicated). Comparing both Groups together, we have noticed that the good clinical result of meniscal sutures with ACL reconstruction associated has occurred faster than isolated meniscal suture, regardless of the meniscus, the knee, and age of the patient. In fact 6 months after surgery, in Group A, there was a success by 65% against 85% for the Group B with 8.3 points International Knee Documentation Committee (IKDC) difference in favor of the latter. Whereas 24 months after surgery, the percentage was increased achieving 90% in Group A and 95% in Group B with 12.6 points IKDC difference in favor of the Group B. A statistical analysis of variable, both after 6 and 24 months, showed a significant improvement of knee conditions for patients with ACL reconstruction.
In conclusion, other than observing the better results in meniscal tears with ACL-deficient knee, we observed that among all cases the best healing occurred in patients affected by meniscal longitudinal vertical tears located in Red-Red zone of external meniscus with an extension of 10 mm in ACL-deficient knee, treated with Fast-Fix suture and ACL reconstruction associated.
本前瞻性研究旨在分析在稳定型与前交叉韧带(ACL)缺失型膝关节中,使用 Fast-Fix All-inside 缝线修复半月板撕裂的结果。
40 名患者,均为职业运动员,均接受关节镜手术,分为两组,并至少随访 24 个月。A 组(稳定膝关节合并单纯半月板撕裂)由 20 例仅接受 Fast-Fix 缝线治疗的患者组成。B 组(ACL 缺失型膝关节合并半月板撕裂)由 20 例同时行 Fast-Fix 缝线修复并进行 ACL 重建(双股腘绳肌腱)的患者组成。将两组进行比较,我们发现,ACL 重建联合半月板缝合的良好临床结果比单纯半月板缝合更快出现,与半月板、膝关节和患者年龄无关。事实上,在术后 6 个月,A 组有 65%的成功率,而 B 组为 85%,后者的国际膝关节文献委员会(IKDC)评分差异为 8.3 分。而在术后 24 个月,A 组的成功率增加至 90%,B 组为 95%,后者的 IKDC 评分差异为 12.6 分。术后 6 个月和 24 个月的变量统计分析均显示,ACL 重建患者的膝关节状况显著改善。
除了观察到 ACL 缺失型膝关节合并半月板撕裂的结果更好之外,我们还观察到,在所有病例中,ACL 缺失型膝关节中,半月板外侧红区纵向垂直撕裂,长度 10mm 以内,采用 Fast-Fix 缝线修复并联合 ACL 重建的患者愈合情况最佳。