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一种关节镜下拔出缝线技术,用于修复外侧半月板后角根部附着处附近的不完全桡侧撕裂,并结合前交叉韧带重建。

An Arthroscopic Pull-Out Suture Technique to Repair Incomplete Radial Tears of the Lateral Meniscus Posterior Horn Adjacent to the Root Attachment Combined With Anterior Cruciate Ligament Reconstruction.

作者信息

Meng Qingyang, Wang Cheng, Wang Jianing, Shi Weili, Chen Nayun, Gao Xin, Ma Yong

机构信息

Department of Sports Medicine, Peking University Third Hospital Institute of Sports Medicine of Peking University Beijing Key Laboratory of Sports Injuries, Beijing, China.

出版信息

Arthrosc Tech. 2022 Nov 18;11(12):e2289-e2293. doi: 10.1016/j.eats.2022.08.038. eCollection 2022 Dec.

Abstract

Radial tears of the lateral meniscus posterior horn are one of the most common lateral meniscal injuries accompanied by acute anterior cruciate ligament disruption. Meniscus-preserving therapy is recommended in the case of a radial lateral meniscal tear to preserve its dynamic behavior. We introduce an arthroscopic pull-out technique for repairing incomplete radial tears of the lateral meniscus posterior horn combined with anterior cruciate ligament reconstruction. In this technique, a ring hoop is made through which the tear ends of lateral meniscus on both sides are tightened by adjusting tension of stitches, providing annular and downward tension for lateral meniscus, both of which are critical to the stability of the lateral meniscus. The resident part of lateral meniscus adjacent to the posterior root is not subject to much tension in this technique because of the pull-out fixation of lateral meniscus posterior horn, thus providing support for healing and restoring the hoop action of the lateral meniscus.

摘要

外侧半月板后角的放射状撕裂是最常见的外侧半月板损伤之一,常伴有急性前交叉韧带断裂。对于外侧半月板放射状撕裂,建议采用保留半月板的治疗方法以保留其动态功能。我们介绍一种关节镜下拔出技术,用于修复外侧半月板后角不完全放射状撕裂并同时进行前交叉韧带重建。在该技术中,制作一个环形箍,通过调节缝线张力将两侧外侧半月板的撕裂端收紧,为外侧半月板提供环形和向下的张力,这两者对于外侧半月板的稳定性至关重要。由于外侧半月板后角的拔出固定,在该技术中,与后根相邻的外侧半月板驻留部分不会受到太大张力,从而为愈合提供支持并恢复外侧半月板的箍状作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e860/9827119/fd861a9f3bde/gr1.jpg

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本文引用的文献

1
Transosseous Meniscus Root Repair in Pediatric Patients and Association With Durable Midterm Outcomes and High Rates of Return to Sports.
Am J Sports Med. 2022 Jul;50(8):2070-2074. doi: 10.1177/03635465221096474. Epub 2022 May 26.
3
All-Inside Repair for Radial Tear at the Posterior Horn of the Lateral Meniscus: A Figure-8 Suture Technique.
Arthrosc Tech. 2021 Jul 20;10(8):e1973-e1977. doi: 10.1016/j.eats.2021.04.021. eCollection 2021 Aug.
5
Increased Posterior Slope of the Medial and Lateral Meniscus Posterior Horn Is Associated With Anterior Cruciate Ligament Injuries.
Arthroscopy. 2022 Jan;38(1):109-118. doi: 10.1016/j.arthro.2021.04.066. Epub 2021 May 6.
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No differences in clinical outcomes and graft healing between anteromedial and central femoral tunnel placement after single bundle ACL reconstruction.
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