Samy Tarek Mohamed, Nassar Wael A M, Zakaria Zeiad Mohamed, Farrag Abdelaziz Ahmed Khaled
Department of Orthopaedic Surgery, Ain Shams University, Cairo, Egypt.
Arthrosc Tech. 2017 May 15;6(3):e579-e583. doi: 10.1016/j.eats.2017.01.001. eCollection 2017 Jun.
Medial meniscus posterior root tear is one of the underestimated knee injuries in terms of incidence. Despite its grave sequelae, using simple but effective technique can maintain the native knee joint longevity. In the current note, a 2-simple-suture pullout technique was used to effectively reduce the meniscus posterior root to its anatomic position. The success of the technique depended on proper tool selection as well as tibial tunnel direction that allowed easier root suturing and better suture tensioning, without inducing any iatrogenic articular cartilage injury or meniscal tissue loss. Using anterior knee arthroscopy portals, anterolateral as a viewing portal and anteromedial as a working portal, a 7-mm tibial tunnel starting at Gerdy tubercle and ending at the medial meniscus posterior root bed was created. The 2 simple sutures were retrieved through the tunnel and tensioned and secured over a 12-mm-diameter washer at the tibial tunnel outer orifice. Anatomic reduction of the medial meniscus posterior root tear was confirmed arthroscopically intraoperatively and radiologically by postoperative magnetic resonance imaging.
内侧半月板后根部撕裂是一种发病率被低估的膝关节损伤。尽管其后果严重,但采用简单而有效的技术可维持天然膝关节的使用寿命。在本报告中,采用一种双简单缝线拔出技术有效地将半月板后根复位至其解剖位置。该技术的成功取决于合适的工具选择以及胫骨隧道方向,这使得更容易进行根部缝合和更好地进行缝线张紧,同时不会引起任何医源性关节软骨损伤或半月板组织丢失。通过前侧膝关节镜入路,以前外侧作为观察入路,前内侧作为操作入路,在Gerdy结节处开始并在内侧半月板后根床处结束创建一个7毫米的胫骨隧道。两根简单缝线通过隧道引出,并在胫骨隧道外口处直径为12毫米的垫圈上张紧并固定。术中通过关节镜确认内侧半月板后根部撕裂的解剖复位,并在术后通过磁共振成像进行放射学确认。