Liu Shoudong, Xie Hongbin, Shan Sen, Liu Nanbo
The Second Department of Orthopedics, the Second Hospital of Chifeng City, Chifeng Inner Mongolia, 024000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Mar 15;36(3):291-295. doi: 10.7507/1002-1892.202110021.
To explore the application value and operation skills of arthroscopic automatic reverse guide wire passer (hereinafter referred to as wire passer) in the posterior meniscus root reconstruction.
Between August 2015 and December 2020, 36 patients with posterior meniscus root tears were admitted. There were 16 males and 20 females, with an average age of 46 years (range, 26-66 years). There were 15 cases of sports injury and 21 cases of degenerative injury. The disease duration was 3-180 days, with a median of 28 days. The posterior root of the medial meniscus was injured in 29 cases, and the posterior root of the lateral meniscus was injured in 7 cases. The preoperative Lysholm score of the knee joint was 47.6±3.9, and the International Knee Score Committee (IKDC) score was 39.3±3.0. The meniscus was sutured by using wire passer under arthroscopy. During operation, the suture operation was evaluated according to the self-defined evaluation standard. Lysholm score and IKDC score were used to evaluate knee joint function.
All meniscuses were sutured successfully by using wire passer. The operation time of suture was 5-15 minutes, with an average of 10 minutes. According to the self-defined evaluation standard, the suture operation was scored as 0-10, with an average of 5. After operation, except for 2 cases of incision fat liquefaction, the incisions of the other patients healed by first intention. All patients were followed up 1-3 years, with an average of 1.5 years. The Lysholm score was 88.2±2.1 and the IKDC score was 51.7±2.3 at 1 year after operation, showing significant difference when compared with preoperative ones ( <0.001). Fifteen cases underwent MRI re-examination, the results showed that the continuity and integrity of the posterior root had been restored.
Under arthroscopy, the wire passer for the posterior meniscus root reconstruction has the advantages of simple operation, reliable suture quality, and shorter operation time.
探讨关节镜下自动反向导丝穿入器(以下简称导丝穿入器)在半月板后根重建中的应用价值及操作技巧。
2015年8月至2020年12月收治36例半月板后根撕裂患者。男16例,女20例,平均年龄46岁(26 - 66岁)。运动损伤15例,退变损伤21例。病程3 - 180天,中位数28天。内侧半月板后根损伤29例,外侧半月板后根损伤7例。膝关节术前Lysholm评分为47.6±3.9,国际膝关节评分委员会(IKDC)评分为39.3±3.0。在关节镜下使用导丝穿入器对半月板进行缝合。术中根据自行制定的评价标准对缝合操作进行评估。采用Lysholm评分和IKDC评分评估膝关节功能。
所有半月板均成功使用导丝穿入器缝合。缝合操作时间为5 - 15分钟,平均10分钟。根据自行制定的评价标准,缝合操作评分为0 - 10分,平均5分。术后除2例切口脂肪液化外,其余患者切口均一期愈合。所有患者随访1 - 3年,平均1.5年。术后1年Lysholm评分为88.2±2.1,IKDC评分为51.7±2.3,与术前相比差异有统计学意义(<0.001)。15例行MRI复查,结果显示后根连续性及完整性已恢复。
关节镜下半月板后根重建用导丝穿入器具有操作简单、缝合质量可靠、手术时间短等优点。