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关节镜下缝合钩全内修复治疗髁间窝区水平撕裂的外侧半月板:初步报告。

Arthroscopic all-inside repair with suture hook for horizontal tear of the lateral meniscus at the popliteal hiatus region: a preliminary report.

机构信息

Department of Joint Surgery, the 6th Hospital of Ningbo, No.1059 Zhongshan road, Yinzhou District, Ningbo, 315000, Zhejiang, People's Republic of China.

Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2020 Jan 29;21(1):52. doi: 10.1186/s12891-020-3066-2.

Abstract

BACKGROUND

Arthroscopic surgery procedures vary depending on the types of meniscus tear, including meniscectomy and meniscus repair. Among the several types of meniscus tear, the horizontal tear of the lateral meniscus at the popliteal hiatus region is a common injury, and its surgical treatment is still inconsistent.

METHODS

Between January 2018 and October 2018, 20 patients who underwent all-inside repair with suture hook for the horizontal tear of the lateral meniscus at the popliteal hiatus region were recruited. Any operative complication was recorded, and postoperative MRI scans were conducted at the 6 months. The clinical results were graded based on the scale of the Lysholm knee score preoperatively and at follow-up.

RESULTS

No operative complications were recorded. Postoperative MRIs at the 6 months showed that there was no re-tear for all patients, though signal intensity remained high in T2-weighted MRI in the lateral meniscus for nine cases. The average preoperative Lysholm knee score was 58.6 ± 10.1, which increased significantly to 89.3 ± 7.8 (t = - 11.01, p = 0.001) at the last follow-up. Recurrence or aggravation of symptoms was not noted at the final follow-up.

CONCLUSION

All-inside repair with suture hook may be a good option for the horizontal tear of the lateral meniscus at the popliteal hiatus region which preserves the meniscus; avoids iatrogenic injury on the adjacent popliteal tendon, common peroneal nerve, and inferior lateral geniculate artery.

摘要

背景

关节镜手术程序因半月板撕裂类型而异,包括半月板切除术和半月板修复术。在几种半月板撕裂中,腘窝间隙外侧半月板的水平撕裂是一种常见损伤,其手术治疗仍不一致。

方法

2018 年 1 月至 2018 年 10 月,我们招募了 20 例接受全内缝合钩修复术治疗腘窝间隙外侧半月板水平撕裂的患者。记录任何手术并发症,并在术后 6 个月进行 MRI 扫描。根据术前和随访时的 Lysholm 膝关节评分量表对临床结果进行分级。

结果

无手术并发症。术后 6 个月的 MRI 显示所有患者均无再撕裂,尽管 9 例外侧半月板 T2 加权 MRI 信号强度仍较高。术前 Lysholm 膝关节评分为 58.6±10.1,末次随访时显著增加至 89.3±7.8(t=-11.01,p=0.001)。末次随访时未发现症状复发或加重。

结论

缝合钩的全内修复可能是治疗腘窝间隙外侧半月板水平撕裂的一种较好方法,因为它可以保留半月板;避免了对相邻的腘肌腱、腓总神经和下外侧膝状动脉的医源性损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d6c/6990581/d5940d3c9ffc/12891_2020_3066_Fig1_HTML.jpg

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