Hu Yuezheng, Xu Xinxian, Pan Xiaoyun, Yu Huachen, Zhang Yu, Wen Hong
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Knee. 2016 Dec;23(6):1143-1147. doi: 10.1016/j.knee.2015.10.011. Epub 2016 Sep 17.
The treatment of discoid meniscus is debatable. This study aimed to assess the clinical efficacy of combined outside-in and FasT-Fix sutures for the treatment of serious discoid meniscal tears.
This study included 32 consecutive patients who underwent arthroscopic meniscal plasty for serious discoid meniscal tears (full-thickness vertical, longitudinal tears >10mm) between October 2006 and June 2012. A combination of outside-in and FasT-Fix sutures was used to treat serious discoid meniscal tears. Disappearance of clinical symptoms (locked knee, pain, and clicking) and negative results in the McMurray and Apley grind tests were assessed during follow-up (26 to 47months). The Lysholm, IKDC, and Tegner scores were assessed for therapeutic efficacy. Some patients were followed up with MRI.
Symptoms (pain, clicking, and locking) disappeared in all patients. The Lysholm score improved from 39.1±9.2 to 89.6±6.7 at six months, and to 90.1±6.3 at the last follow-up. The same trends were observed for the IKDC score (from 38.0±9.5 to 90±6.3, and to 91.1±6.4) and the Tegner score (from 2.8±0.6 to 5.2±0.6, and to 5.2±0.5). Among all patients, 13 were followed up with MRI. Among these patients, four had an unhealed stitched edge, but they did not complain of any discomfort in the knees.
The use of a combination of outside-in and FasT-Fix sutures for meniscal plasty had good outcomes for serious discoid meniscal tears and can thus be regarded as a good surgical option.
盘状半月板的治疗存在争议。本研究旨在评估由外向内缝合联合FasT-Fix缝线治疗严重盘状半月板撕裂的临床疗效。
本研究纳入了2006年10月至2012年6月期间连续32例因严重盘状半月板撕裂(全层垂直、纵向撕裂>10mm)接受关节镜下半月板成形术的患者。采用由外向内缝合联合FasT-Fix缝线治疗严重盘状半月板撕裂。随访(26至47个月)期间评估临床症状(膝关节交锁、疼痛和弹响)消失情况以及麦氏试验和阿普利研磨试验结果为阴性的情况。采用Lysholm、IKDC和Tegner评分评估治疗效果。部分患者接受了MRI随访。
所有患者的症状(疼痛、弹响和交锁)均消失。Lysholm评分在6个月时从39.1±9.2提高到89.6±6.7,末次随访时提高到90.1±6.3。IKDC评分(从38.0±9.5提高到90±6.3,末次随访时提高到91.1±6.4)和Tegner评分(从2.8±0.6提高到5.2±0.6,末次随访时提高到5.2±0.5)也呈现相同趋势。所有患者中,13例接受了MRI随访。在这些患者中,4例缝合边缘未愈合,但他们未诉膝关节有任何不适。
由外向内缝合联合FasT-Fix缝线进行半月板成形术治疗严重盘状半月板撕裂效果良好,因此可被视为一种良好的手术选择。