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关节镜下半月板损伤的处理:半月板 dart 缝合技术(由外向内缝合)。

ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES IN ADOLESCENTS: OUTSIDE-IN SUTURING MENISCAL DART TECHNIQUE.

机构信息

1Department of Pediatric Surgery, Split University Hospital Centre, Split, Croatia; 2University of Split, School of Medicine, Split, Croatia; 3Department of Anatomy, University of Split, School of Medicine, Split, Croatia.

出版信息

Acta Clin Croat. 2020 Sep;59(3):431-438. doi: 10.20471/acc.2020.59.03.06.

Abstract

The aim of this study was to evaluate clinical and subjective outcomes of the meniscal dart technique in patients having undergone arthroscopic meniscal repair by comparing it with the outside-in suturing technique. From January 2006 until June 2017, case records of 37 patients having undergone arthroscopic meniscal repair were retrospectively reviewed. The patients were divided into two groups based on the technique used for meniscal repair, as follows: 18 patients in suture technique group and 19 patients in meniscal dart group. Each patient was analyzed for the following parameters: age, gender, mechanism of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and results of follow-up (Lysholm and International Knee Documentation Committee (IKDC) score). There were no statistically significant differences between the groups according to clinical outcomes except for anatomic injury localization (p=0.035). Median of operation time was 62.5 min in suture technique group and 70 min in meniscal dart group (p=0.184); median of hospital stay was 2 days for both groups (p=0.951); median of Lysholm score was 86.5 and 84.5 (p=0.651); and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support arthroscopic repair of meniscal tears, since both the suture technique and the meniscal dart technique are safe and successful in meniscal repair in children, with good long-term results and without important complications.

摘要

本研究旨在通过对比关节镜半月板修复术中半月板缝合技术与半月板 dart 技术,评估这两种技术的临床和主观疗效。2006 年 1 月至 2017 年 6 月,回顾性分析了 37 例行关节镜半月板修复术患者的病例记录。根据半月板修复技术将患者分为两组:缝合技术组 18 例,半月板 dart 组 19 例。对每位患者分析以下参数:年龄、性别、损伤机制、损伤侧和损伤半月板、半月板损伤的解剖位置、损伤类型和相关损伤。对接受半月板修复的患者分析修复技术类型、手术结果和随访结果(Lysholm 和国际膝关节文献委员会(IKDC)评分)。除解剖损伤定位外(p=0.035),两组患者的临床结果无统计学差异。缝合技术组的手术时间中位数为 62.5 分钟,半月板 dart 组为 70 分钟(p=0.184);两组的住院时间中位数均为 2 天(p=0.951);Lysholm 评分中位数分别为 86.5 和 84.5(p=0.651);IKDC 评分中位数分别为 81.05 和 81.6,两组间差异无统计学意义(p=0.986)。了解半月板切除术的危害后,应尽可能尝试关节镜下半月板修复。我们的数据支持关节镜下半月板撕裂修复,因为半月板缝合技术和半月板 dart 技术在儿童半月板修复中都是安全且有效的,具有良好的长期效果,且无重要并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5797/8212661/941aab0da021/ACC-59-431-f1.jpg

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