Koga Hideyuki, Muneta Takeshi, Yagishita Kazuyoshi, Watanabe Toshifumi, Mochizuki Tomoyuki, Horie Masafumi, Nakamura Tomomasa, Okawa Atsushi, Sekiya Ichiro
Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
Arthrosc Tech. 2012 Oct 22;1(2):e209-12. doi: 10.1016/j.eats.2012.08.001. Print 2012 Dec.
Extrusion of the lateral meniscus has been reported after posterior root tear or radial tear, partial meniscectomy, and meniscoplasty of discoid meniscus. It has also been shown to be associated with the development of osteoarthritis. This technical note describes a new arthroscopic technique to centralize and stabilize the mid body of the lateral meniscus to restore and maintain the lateral meniscus function by repairing/preventing extrusion of the meniscus. A JuggerKnot Soft Anchor (Biomet, Warsaw, IN), loaded with a MaxBraid suture (Biomet), was placed on the lateral edge of the lateral tibial plateau, just anterior to the popliteal hiatus, through a midlateral portal. A Micro Suture Lasso Small Curve with Nitinol Wire Loop (Arthrex, Naples, FL) was used to pass 2 limbs of the MaxBraid suture through the meniscus at the margin between the meniscus and the capsule. Another anchor was inserted on the lateral edge of the lateral tibial plateau, 1 cm anterior to the first anchor, and the same procedure was repeated. The sutures were then tied by use of a self-locking sliding knot, achieving centralization and secure stabilization of the lateral meniscus.
外侧半月板后根撕裂或放射状撕裂、部分半月板切除术以及盘状半月板成形术后,均有外侧半月板挤出的报道。研究还表明,外侧半月板挤出与骨关节炎的发展有关。本技术说明介绍了一种新的关节镜技术,通过修复/防止半月板挤出,使外侧半月板中部复位并稳定,以恢复和维持外侧半月板功能。将装有MaxBraid缝线(Biomet公司生产)的JuggerKnot软锚钉(Biomet公司,印第安纳州华沙市)经中外侧入路置于外侧胫骨平台外侧边缘,即腘肌裂孔前方。使用带有镍钛合金丝环的微型缝线套索小弯(Arthrex公司,佛罗里达州那不勒斯市),将MaxBraid缝线的两股线穿过半月板与关节囊交界处的半月板。在第一个锚钉前方1 cm处的外侧胫骨平台外侧边缘插入另一个锚钉,并重复相同操作。然后使用自锁滑动结系紧缝线,实现外侧半月板的复位和牢固稳定。