Chen Zhong, Li Wei-Ping, Yang Rui, Song Bin, Jiang Chuan, Hou Jing-Yi, Luo Huan, Zhou Yun-Feng
Department of Orthopaedic Surgery, Sport Medicine Center, Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, City of Guangzhou, Guang Dong Province, Republic of China.
J Knee Surg. 2018 Sep;31(8):710-715. doi: 10.1055/s-0037-1606378. Epub 2017 Sep 5.
Although the suture-hook technique remains popular for meniscal ramp lesions, which frequently occur after anterior cruciate ligament (ACL) injury, it is unclear whether the all-inside FasT-Fix technique (Smith & Nephew, Andover, MA) is appropriate for the repair of ramp lesions. This study evaluated results of arthroscopic FasT-Fix meniscal ramp lesion repair using second-look arthroscopy. From August 2010 to December 2014, 46 knees diagnosed with combined ACL injury and ramp lesion underwent ACL reconstruction with meniscal repair using the FasT-Fix technique. We classified ramp lesions into three types according to tear pattern: meniscotibial ligament tear, meniscocapsular tear, and combined meniscotibial/meniscocapsular tear. Second-look arthroscopy was performed postoperatively. The healing capacity of the ramp lesion was evaluated retrospectively. At the final follow-up (mean = 32 months), the Lysholm knee score and the International Knee Documentation Committee (IKDC) objective score were compared with preoperative scores. All patients ( = 46) underwent a second-look arthroscopy, with 45 (97.8%) exhibiting complete or partial healing after the FasT-Fix technique was used in conjunction with ACL reconstruction. The Lysholm knee score and IKDC objective score were significantly better than preoperative scores at final follow-up. The FasT-Fix technique for meniscal ramp lesion repair-when performed with concomitant ACL reconstruction-exhibits excellent healing results.
尽管缝线钩技术在半月板斜坡损伤（常发生于前交叉韧带 [ACL] 损伤后）的治疗中仍然很常用，但全关节内FasT-Fix技术（史赛克公司，安多弗，马萨诸塞州）是否适用于斜坡损伤的修复尚不清楚。本研究通过二次关节镜检查评估了关节镜下FasT-Fix技术修复半月板斜坡损伤的效果。2010年8月至2014年12月，46例诊断为合并ACL损伤和斜坡损伤的膝关节采用FasT-Fix技术进行ACL重建及半月板修复。我们根据撕裂类型将斜坡损伤分为三种类型：半月板胫骨韧带撕裂、半月板关节囊撕裂以及半月板胫骨/半月板关节囊联合撕裂。术后进行二次关节镜检查。回顾性评估斜坡损伤的愈合能力。在末次随访时（平均32个月），将Lysholm膝关节评分和国际膝关节文献委员会（IKDC）客观评分与术前评分进行比较。所有46例患者均接受了二次关节镜检查，其中45例（97.8%）在FasT-Fix技术联合ACL重建后显示完全或部分愈合。在末次随访时，Lysholm膝关节评分和IKDC客观评分显著优于术前评分。FasT-Fix技术用于半月板斜坡损伤修复并同时进行ACL重建时，显示出优异的愈合效果。
