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经胫骨外侧半月板根部修复技术:用双加压结将残留根部与撕裂的半月板体部对合

Transtibial Lateral Meniscal Root Repair Technique to Appose Remnant Root With Torn Body: The Double Compression Knot.

作者信息

Da Costa Xavier, Dan Michael J, Cance Nicolas, Navarro Severine, Demey Guillaume, Dejour David H

机构信息

Orthopedic Surgery Department, Lyon Ortho Clinic, Clinique de la Sauvegarde, Lyon, France.

Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School University of New South Wales, Sydney, Australia.

出版信息

Arthrosc Tech. 2024 Jan 1;13(2):102860. doi: 10.1016/j.eats.2023.10.003. eCollection 2024 Feb.

Abstract

Anterior cruciate ligament reconstructions are often performed with associated procedures, most commonly for associated meniscal tears. The lateral meniscal root tear is a commonly associated injury, which increases rotational instability and results in altered tibiofemoral biomechanics. Lateral meniscectomy results in poorer functional and long-term outcomes, making repair vital. The position of the lateral root tear makes its repair technique complicated. Because of the proximity to vessels posteriorly, the all-inside technique is considered potentially unsafe, and current transtibial repair techniques fail to appose the body with the root remnant. In the lineage of Laprade, who proclaimed the use of a transtibial suture for radial tears elsewhere in the knee in order to reduce the shear force, we describe a transtibial technique that optimizes meniscal apposition, theoretically improving the repair biomechanics and is technically easier to perform in comparison to suture hook techniques with one tunnel and one suture.

摘要

前交叉韧带重建术通常会与相关手术一起进行,最常见的是针对合并的半月板撕裂。外侧半月板根部撕裂是一种常见的合并损伤,它会增加旋转不稳定,并导致胫股生物力学改变。外侧半月板切除术会导致较差的功能和长期预后,因此修复至关重要。外侧根部撕裂的位置使其修复技术复杂。由于后方靠近血管,全关节镜技术被认为存在潜在风险,而目前的经胫骨修复技术无法使半月板体部与根部残端对合。在Laprade的方法基础上(Laprade主张在膝关节其他部位对放射状撕裂使用经胫骨缝线以减少剪切力),我们描述了一种经胫骨技术,该技术可优化半月板对合,理论上改善修复生物力学,并且与单隧道单缝线的缝线钩技术相比,在技术上更易于操作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aae0/10907937/e40bcab693e6/gr1.jpg

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