Joshi Amit, Basukala Bibek, Singh Nagmani, Hama Bhadra, Bista Rohit, Pradhan Ishor
AKB Center for Arthroscopy, Sports Injuries and Regenerative Medicine, B&B Hospital, Gwarko, Nepal.
Arthrosc Tech. 2020 Mar 3;9(4):e407-e417. doi: 10.1016/j.eats.2019.11.016. eCollection 2020 Apr.
Meniscal tears are commonly encountered conditions of the knee. In the past, torn menisci were treated by excision of the loose flap. A better understanding of the meniscus anatomy and its biomechanical characteristics has led to the concept of meniscus preservation in eligible cases. Several suture-based repair techniques have been described in literature, including the outside-in technique. Although the outside-in technique of meniscus repair is commonly indicated for the anterior two-thirds of the meniscus, it can be used to repair the posterior part of the meniscus as well. Several modifications of this technique have been described in the literature. We hereby describe our modification of the outside-in technique of meniscus repair with the help of an epidural needle and high-strength sutures that is readily available in operating rooms. The advantages of our technique are that no large incision is required around knee joint, it's inexpensive, it can be performed with basic instruments, and even the tear of meniscus extending up to the posterior horn can be repaired. A supplemental video demonstration of the technique is included with this article.
半月板撕裂是膝关节常见的病症。过去，撕裂的半月板通过切除游离瓣来治疗。对半月板解剖结构及其生物力学特性的更好理解，催生了在合适病例中保留半月板的概念。文献中描述了几种基于缝合的修复技术，包括由外向内技术。尽管半月板修复的由外向内技术通常适用于半月板前三分之二的部分，但它也可用于修复半月板的后部。文献中描述了该技术的几种改良方法。在此，我们借助硬膜外穿刺针和手术室中 readily available 的高强度缝线，描述我们对半月板修复由外向内技术的改良。我们技术的优点是膝关节周围无需做大切口，成本低廉，使用基本器械即可完成，甚至半月板延伸至后角的撕裂也能修复。本文还附带了该技术的补充视频演示。
