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采用前束松解术修复盘状外侧半月板周边型撕裂

Meniscus Repair With Anterior Cord Release for Peripheral Tear Type of Discoid Lateral Meniscus.

作者信息

Suzuki Tomoyuki, Matsumura Takashi, Otsubo Hidenori, Kuroda Miki

机构信息

Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Chuo-ku, Sapporo, Hokkaido, Japan.

Department of Orthopaedic Surgery, Obihiro Kyokai Hospital, Chuo-ku, Sapporo, Hokkaido, Japan.

出版信息

Arthrosc Tech. 2021 Feb 1;10(2):e353-e357. doi: 10.1016/j.eats.2020.10.016. eCollection 2021 Feb.

Abstract

With improvement in arthroscopic techniques, partial meniscectomy with repair for symptomatic discoid lateral meniscus (DLM) has been the preferred treatment to restore meniscal function. It was reported that DLM exhibited deformation and extrusion shortly after saucerization with repair. Therefore it is desirable to minimize removal of the DLM. The anterior zone of the DLM is often tighter than that of the normal meniscus and anatomic variant. It is considered that the anterior and anterocentral dislocation types in the majority of symptomatic DLM can be related to both peripheral instability and anterior tightness. We present a technique that, first, the inside-out repair technique is applied from the posterior to middle segment of the DLM; next, the tension of the anterior zone during knee flexion-extension is confirmed to determine the released amount of that part; and, finally, all sutures are tied to reproduce the normal meniscus movement. Meniscus repair with anterior cord release without any meniscectomy could resolve peripheral instability of DLM and prevent degeneration of the articular cartilage.

摘要

随着关节镜技术的进步,对于有症状的盘状外侧半月板(DLM)进行部分半月板切除术并修复已成为恢复半月板功能的首选治疗方法。据报道,DLM在碟形化修复后不久就会出现变形和挤压。因此,希望尽量减少DLM的切除。DLM的前部区域通常比正常半月板和解剖变异的前部区域更紧。据认为,大多数有症状的DLM的前部和前中部脱位类型可能与周边不稳定和前部紧张有关。我们提出一种技术,首先,从DLM的后部到中部应用由内向外修复技术;其次,确认膝关节屈伸过程中前部区域的张力,以确定该部分的释放量;最后,系紧所有缝线以重现正常半月板运动。不进行任何半月板切除术的前索释放半月板修复术可以解决DLM的周边不稳定问题,并防止关节软骨退变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d743/7917086/f88c9f0f2c07/gr1.jpg

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