Okazaki Yoshiki, Furumatsu Takayuki, Miyazawa Shinichi, Masuda Shin, Okazaki Yuki, Hiranaka Takaaki, Ozaki Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School, 2-5-1 Shikata-cho, Kitaku, Okayama, 700-8558, Japan.
Eur J Orthop Surg Traumatol. 2019 Dec;29(8):1805-1809. doi: 10.1007/s00590-019-02513-4. Epub 2019 Jul 26.
The medial meniscus (MM) posterior root has important functions in preventing an excessive loading stress during knee motion and degeneration of the articular cartilage. Although the transtibial pullout repair has become the gold standard for MM posterior root tears (MMPRTs), MM extrusion remains. In addition, during knee extension to deep flexion, the MM posterior segment in the MMPRT knee has been shown to translate toward the posteromedial direction, causing a notable MM posterior extrusion. Thus, the reduction in the MM posteromedial extrusion is one of the important postoperative outcomes to restore the meniscal function and eventually prevent the progression of knee osteoarthritis. The present technical note describes an arthroscopic technique addition to the pullout repair, in which an all-inside suture is inserted into the posteromedial part of the MM to reduce the MM posteromedial extrusion.
内侧半月板(MM)后根在防止膝关节运动期间过度负荷应力以及关节软骨退变方面具有重要作用。尽管经胫骨拉出修复术已成为MM后根撕裂(MMPRTs)的金标准,但MM仍会出现挤压。此外,在膝关节从伸展到深度屈曲的过程中,MMPRT膝关节中的MM后段已被证明会向后内侧方向移位,导致明显的MM后内侧挤压。因此,减少MM后内侧挤压是恢复半月板功能并最终防止膝关节骨关节炎进展的重要术后结果之一。本技术说明描述了一种在拉出修复术基础上增加的关节镜技术,即在MM的后内侧部分插入全内缝线以减少MM后内侧挤压。