Kim Seong Hwan, Lipinski Lukasz, Pujol Nicolas
Department of Orthopedic Surgery, Centre Hospitalier de Versailles, Le Chesnay, France.
Department of Orthopedic Surgery, Hyundae General Hospital, Chung-Ang University, Seoul, Republic of Korea.
Arthrosc Tech. 2019 Dec 24;9(1):e137-e142. doi: 10.1016/j.eats.2019.09.015. eCollection 2020 Jan.
Meniscal allograft transplantation has been introduced as a treatment for symptomatic meniscus-deficient patients to improve clinical outcomes. We describe an arthroscopic technique for meniscal allograft with soft-tissue fixation including the anterior intermeniscal ligament (AIML): arthroscopic double soft-tissue fixation technique. The AIML and anterior and posterior roots are detached and sutured using running locked Krackow stitches. After preparation of the meniscal bed, the meniscus is passed into the knee and the posterior meniscal horn is fixed with sutures through bone tunnels. The body of the meniscus is fixed with all-inside sutures. Then, the anterior meniscal suture is fixed on the anatomic point of the anterior root with an anchor. The AIML suture is fixed with an anchor to the bare area of the proximal tibia, anterior to the anterior cruciate ligament insertion. This reliable and reproducible technique is less complex than bone plug methods; it is less invasive but still provides stable and secure graft fixation. It will help surgeons to improve clinical results and to limit early secondary extrusion of the graft.
半月板同种异体移植已被引入作为有症状的半月板缺损患者的一种治疗方法，以改善临床疗效。我们描述了一种用于半月板同种异体移植的关节镜技术，该技术采用包括前半月板间韧带（AIML）在内的软组织固定：关节镜双软组织固定技术。将AIML以及前后根部游离并使用连续锁定Krackow缝线进行缝合。在准备好半月板床后，将半月板放入膝关节，通过骨隧道用缝线固定后半月板角。半月板体部用全内缝线固定。然后，将半月板前缝线用锚钉固定在前根部的解剖位置。将AIML缝线用锚钉固定在胫骨近端的裸区，即前交叉韧带附着点前方。这种可靠且可重复的技术比骨栓方法更简单；它的侵入性较小，但仍能提供稳定可靠的移植物固定。这将有助于外科医生改善临床结果并限制移植物早期继发性挤出。
