Kale Sachin, Deore Sandeep, Gunjotikar Aditya, Singh Sushmit, Ghodke Rahul, Agrawal Parth
Department of Orthopaedics, Dr. D Y Patil Medical College, Nerul, Navi Mumbai, India.
Department of Orthopaedics, YMT College and Hospital, Navi Mumbai, India.
J Clin Orthop Trauma. 2022 Aug 6;32:101969. doi: 10.1016/j.jcot.2022.101969. eCollection 2022 Sep.
This study was proposed to evaluate the efficacy of fibrin clot augmentation in meniscal tear using inside-out meniscal repair.
A total of 35 patients with meniscus tears were operated on with inside-out meniscus repair and fibrin clot augmentation. Patients were evaluated preoperatively and postoperatively with clinical criteria, Lysholm knee scoring system, and MRI.
Out of the total 35 cases, 5 cases were lost to follow-up. Clinical improvement was observed in 29 out of 30 patients (96.6%). The mean Lysholm score improved significantly from 67.63 ± 6.55 points preoperatively to 92.0 ± 2.9 points postoperatively (P < 0.05) in 3 years follow-up. Follow-up MRI in all patients revealed complete healing except in 1 case where the patient presented with recurrence of symptoms such as pain and locking which resolved with partial meniscectomy. Paraesthesia in the anterior part of the knee was observed in 2 cases. (6.6%).
We conclude that fibrin clot augmentation is a good cost-effective modality of treatment for repairable meniscus tears to preserve the meniscus and decrease the point contact pressure on the condyles which may prevent the early occurrence of osteoarthritis.
本研究旨在评估采用由外向内半月板修复术时,纤维蛋白凝块增强术治疗半月板撕裂的疗效。
共有35例半月板撕裂患者接受了由外向内半月板修复术及纤维蛋白凝块增强术。术前及术后采用临床标准、Lysholm膝关节评分系统和磁共振成像(MRI)对患者进行评估。
35例患者中,5例失访。30例患者中有29例(96.6%)临床症状改善。在3年的随访中,Lysholm评分均值从术前的67.63±6.55分显著提高至术后的92.0±2.9分(P<0.05)。所有患者的随访MRI显示,除1例患者出现疼痛和绞锁等症状复发,经部分半月板切除术缓解外,其余患者均完全愈合。2例患者(6.6%)出现膝前部感觉异常。
我们得出结论,纤维蛋白凝块增强术是一种性价比高的治疗可修复半月板撕裂的方法,可保留半月板并降低髁间的点接触压力,这可能会预防骨关节炎的早期发生。