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半月板同种异体移植术中半月板后三分之一的修复:传统的由外向内修复与 FasT-Fix 全关节内修复的比较

Repair of the Posterior Third of the Meniscus During Meniscus Allograft Transplantation: Conventional Inside-Out Repair Versus FasT-Fix All-Inside Repair.

作者信息

Ahn Ji Hyun, Kim Chang Hee, Lee Sung Hyun

机构信息

Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Gyeonggido, Republic of Korea.

Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Gyeonggido, Republic of Korea.

出版信息

Arthroscopy. 2016 Feb;32(2):295-305. doi: 10.1016/j.arthro.2015.07.017. Epub 2015 Sep 28.

Abstract

PURPOSE

To compare conventional inside-out (IO) repair and all-inside (AI) repair for the posterior third of the meniscus during meniscus allograft transplantation (MAT).

METHODS

Among the 64 enrolled patients, 31 patients underwent MAT with conventional IO repair, and 33 patients underwent MAT with AI repair using the FasT-Fix instrument for the posterior third of the meniscus allograft. All of the patients were retrospectively evaluated through clinical assessment at the last follow-up (54.3 months in the IO group and 55.4 months in the AI group) and through magnetic resonance imaging assessment for meniscal extrusion at 1 year postoperatively. Thirty patients (15 in each group) were evaluated through second-look arthroscopy at 1 year postoperatively.

RESULTS

There was no significant difference in the mean Lysholm score (91.3 in the IO group and 92.3 in the AI group; P = .358) or the mean Tegner activity scale (7.1 in each group; P = .885) between the 2 groups. There was no significant difference in the mean meniscal extrusion (2.6 mm in the IO group and 2.8 mm in the AI group; P = .454), relative percentage of extrusion value (25.6% in the IO group and 24.7% in the AI group; P = .721), or meniscal healing on second-look arthroscopy (P = .796) between the 2 groups. The difference in operative time between the 2 groups was found to be statistically significant (169.9 minutes in the IO group and 123.3 minutes in the AI group; P < .001).

CONCLUSIONS

Our comparative study on the different techniques for posterior repair of meniscus allograft suggested that AI posterior repair using FasT-Fix could be an alternative method to conventional IO repair as it gives a similar postoperative result and requires a shorter operative time.

摘要

目的

比较在半月板同种异体移植(MAT)过程中,传统的由外向内(IO)修复和全内(AI)修复半月板后三分之一的效果。

方法

在64例入选患者中,31例患者接受了采用传统IO修复的MAT,33例患者接受了采用FasT-Fix器械对半月板同种异体移植后三分之一进行AI修复的MAT。所有患者均在末次随访时(IO组为54.3个月,AI组为55.4个月)通过临床评估进行回顾性评价,并在术后1年通过磁共振成像评估半月板挤出情况。30例患者(每组15例)在术后1年通过二次关节镜检查进行评价。

结果

两组之间的平均Lysholm评分(IO组为91.3,AI组为92.3;P = 0.358)或平均Tegner活动量表评分(每组均为7.1;P = 0.885)无显著差异。两组之间的平均半月板挤出量(IO组为2.6 mm,AI组为2.8 mm;P = 0.454)、挤出值相对百分比(IO组为25.6%,AI组为24.7%;P = 0.721)或二次关节镜检查时的半月板愈合情况(P = 0.796)无显著差异。发现两组之间的手术时间差异具有统计学意义(IO组为169.9分钟,AI组为123.3分钟;P < 0.001)。

结论

我们对半月板同种异体移植后修复不同技术的比较研究表明,使用FasT-Fix进行AI后修复可以作为传统IO修复的替代方法,因为它能产生相似的术后结果且手术时间更短。

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