Department of Orthopedics, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People's Republic of China.
Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
BMC Musculoskelet Disord. 2021 Jan 12;22(1):66. doi: 10.1186/s12891-020-03911-0.
To investigate factors associated with the consumption of a large number of sutures during arthroscopic meniscus repair procedures.
All patients who received meniscal repair, with or without concomitant anterior cruciate ligament (ACL) reconstruction, in our hospital from January 2015 to December 2019 were included in the current study. Demographic data (sex, age, body mass index (BMI), and injury-to-surgery interval) and surgical data (the site of the tear, side of the meniscus, presence of an ACL rupture or not and the number of sutures) were retrospectively collected from our medical records. The number of sutures was divided into two groups (1-2 sutures versus > 2 sutures). The stitching process was implemented through an all-inside technique using a meniscal repair device (Fast-Fix; Smith & Nephew). According to the length and stability of the meniscal tear, one to seven sutures were used. Univariate analysis consisted of chi-square tests. Multivariate logistic regression was then performed to adjust for confounding factors.
A total of 242 patients, including 168 males and 57 females, was finally included. In the univariate analysis, we found that those patients who underwent meniscus repair within one month after meniscus tear were more likely to need fewer sutures than those who underwent surgery more than one month after injury (70/110 versus 59/115, p=0.062). In total, 75/109 (68.8%) lateral meniscal tears were repaired with fewer sutures than medial (34/72, 47.2%) and bilateral meniscus injuries (20/44, 45.4%; p=0.003). In the multivariate analysis, we found that the duration of injury (OR, 2.06; 95% CI, 1.16-3.64, p=0.013), presence of an ACL injury (OR, 3.76; 95% CI, 1.97-7.21, p< 0.001) and the side of the meniscus (OR, 0.31; 95% CI, 0.14-0.65, p=0.002) were associated with the number of sutures used during meniscal repair procedures.
Patients who underwent meniscal repair within one month after meniscus tear, especially lateral menisci tears, were more likely to need fewer sutures.
Case-control study; level of evidence, 3.
研究与关节镜半月板修复术中使用大量缝线相关的因素。
本研究纳入了 2015 年 1 月至 2019 年 12 月在我院接受半月板修复术（伴或不伴前交叉韧带 [ACL] 重建）的所有患者。从病历中回顾性收集了人口统计学数据（性别、年龄、体重指数 [BMI]、受伤至手术的时间间隔）和手术数据（撕裂部位、半月板侧、ACL 是否破裂以及缝线数量）。缝线数量分为两组（1-2 根缝线与>2 根缝线）。缝合过程采用全内技术（Fast-Fix；Smith & Nephew）使用半月板修复装置进行。根据半月板撕裂的长度和稳定性，使用 1 到 7 根缝线。单变量分析包括卡方检验。然后进行多变量逻辑回归以调整混杂因素。
最终纳入 242 例患者，其中男 168 例，女 57 例。在单变量分析中，我们发现半月板撕裂后 1 个月内接受半月板修复的患者比受伤后 1 个月以上接受手术的患者需要的缝线更少（70/110 与 59/115，p=0.062）。总共，75/109（68.8%）外侧半月板撕裂需要的缝线比内侧（34/72，47.2%）和双侧半月板损伤（20/44，45.4%）更少（p=0.003）。在多变量分析中，我们发现受伤时间（OR，2.06；95%CI，1.16-3.64，p=0.013）、ACL 损伤（OR，3.76；95%CI，1.97-7.21，p<0.001）和半月板侧（OR，0.31；95%CI，0.14-0.65，p=0.002）与半月板修复术中使用的缝线数量相关。
半月板撕裂后 1 个月内接受半月板修复的患者，尤其是外侧半月板撕裂的患者，需要的缝线更少。
病例对照研究；证据水平，3 级。
