Beaufils P, Pujol N
Service d'orthopédie traumatologie, centre hospitalier de Versailles, 78150 Le Chesnay, France.
Service d'orthopédie traumatologie, centre hospitalier de Versailles, 78150 Le Chesnay, France.
Orthop Traumatol Surg Res. 2018 Feb;104(1S):S137-S145. doi: 10.1016/j.otsr.2017.04.016. Epub 2017 Nov 23.
Meniscal repair aims to achieve meniscal healing, avoiding the adverse effects of meniscectomy. Longitudinal vertical tears in a vascularized area are the reference indication. The technique generally uses hybrid all-inside implants. The outside-in technique has other indications in more anterior tears. Healing has been demonstrated on CT-arthrography and arthroscopy. Specific techniques have been developed for other pathological situations. Posterior meniscosynovial lesions in a context of chronic anterior laxity are identified by exploration of the posterior compartment, and fixed by all-inside hook suture. Horizontal lesions in young athletes can be treated by open meniscal suture. Radial tears, when deep, can be repaired. Root tears, when traumatic, can be treated by transosseous pullout reinsertion.
半月板修复旨在实现半月板愈合,避免半月板切除术的不良影响。血管化区域的纵向垂直撕裂是参考指征。该技术通常使用混合全内植入物。由外向内技术在更靠前的撕裂中有其他指征。在CT关节造影和关节镜检查中已证实愈合情况。针对其他病理情况已开发出特定技术。在慢性前交叉韧带松弛情况下的后半月板滑膜损伤通过探查后关节腔来识别,并用全内钩状缝合固定。年轻运动员的水平损伤可通过开放半月板缝合治疗。深度放射状撕裂可以修复。创伤性根部撕裂可通过经骨拔出再植入治疗。