Aşçi Murat, Balta Orhan, Kurnaz Recep, Eren Mehmet Burtaç, Kuyucu Yunus Emre, Güneş Taner
Gaziosmanpaşa University, School of Medicine, Department of Orthopaedics and Traumatology, Tokat, Turkey.
Acıbadem University, Eskişehir Acıbadem Hospital, Department of Orthopaedics and Traumatology, Eskişehir, Turkey.
Acta Orthop Traumatol Turc. 2018 Sep;52(5):392-396. doi: 10.1016/j.aott.2018.07.002. Epub 2018 Aug 16.
Radial meniscus tears are seen in young patients, especially with anterior cruciate ligament ruptures. Repair of complete radial meniscus tear is necessary for the meniscus functions. The most important factor for success of the meniscus repair is primary stability, but it is still unknown which technique is ideal repair technique.
We developed a new suture technique named Horizontal Butterfly (HB). In this novel technique the contact between meniscal tissue and suture is more than Horizontal Loop (HL) that routinely used today. So, we think that this technique will provide better fixation than HL. We aimed to compare 2 repair techniques (HB vs. HL) using human lateral menisci biomechanically with cyclic loading and load to failure tests.
MATERIAL-METHOD: We used 22 intact lateral meniscus obtained from patients that operated (total knee replacement) for varus gonarthrosis in our clinic. All menisci were cut radially. In the first group (n:11) menisci were repaired with standard horizontal loop technique, and in the second group (n:11) horizontal butterfly technique were used for repair. All specimens were tested with load to failure test after cyclic loading test (500 cycle X 5-30 N).
Both groups have similar failure load (71,4 ± 17,52 N vs. 77,9 ± 28,49 N; p:0,559) and stiffness (24,46 ± 19,19 N vs. 24,48 ± 15,87 N; p:0,818). HB group has less peak displacement (6,26 ± 1,24 mm vs. 8,4 ± 1,92 mm; p:0,010).
This novel repair technique decreases the amount of displacement according to standard technique while as strong as standard technique routinely used. In this way; we believe that it will increase the rate of healing in clinical use.
桡侧半月板撕裂多见于年轻患者，尤其是合并前交叉韧带断裂时。对于半月板功能而言，修复完全性桡侧半月板撕裂很有必要。半月板修复成功的最重要因素是初始稳定性，但目前仍不清楚哪种技术是理想的修复技术。
我们研发了一种名为水平蝶形（HB）的新缝合技术。在这种新技术中，半月板组织与缝线之间的接触比当今常规使用的水平环（HL）更多。因此，我们认为该技术将比HL提供更好的固定效果。我们旨在通过循环加载和失效载荷试验，对两种修复技术（HB与HL）进行人体外侧半月板的生物力学比较。
我们使用了从我院因膝内翻骨关节炎接受手术（全膝关节置换）的患者身上获取的22个完整外侧半月板。所有半月板均进行了径向切割。第一组（n = 11）半月板采用标准水平环技术修复，第二组（n = 11）采用水平蝶形技术修复。所有标本在循环加载试验（500次循环×5 - 30 N）后进行失效载荷试验。
两组的失效载荷（71.4±17.52 N对77.9±28.49 N；p = 0.559）和刚度（24.46±19.19 N对24.48±15.87 N；p = 0.818）相似。HB组的峰值位移较小（6.26±1.24 mm对8.4±1.92 mm；p = 0.010）。
这种新的修复技术在与常规使用的标准技术强度相同的情况下，根据标准技术减少了位移量。通过这种方式，我们相信它将提高临床应用中的愈合率。
