在猪模型的关节镜控制训练中,与传统垂直褥式缝合技术相比,连续半月板修复技术可缩短手术时间并降低学习曲线。
Continuous Meniscal Repair Technique Allows for Shorter Operative Time and Learning Curve Compared With Traditional Vertical Mattress Technique in Controlled Arthroscopic Training in Porcine Model.
作者信息
Rocha de Faria José Leonardo, Neto João Vieira de Almeida, Gonçalves Bruno Couto, Pavão Douglas Mello, Guimarães João Antonio Matheus, de Oliveira Valdeci Manoel, LaPrade Robert F, Ricardo Djalma Rabelo, Salim Rodrigo
机构信息
Knee Surgery Center, National Institute of Traumatology and Orthopedics (INTO), Rio de Janeiro, RJ, Brazil.
School of Medicine from University of São Paulo-USP Ribeirão Preto, SP, Brazil.
出版信息
Arthrosc Sports Med Rehabil. 2024 Jun 10;6(5):100957. doi: 10.1016/j.asmr.2024.100957. eCollection 2024 Oct.
PURPOSE
To compare the amount of time used to perform meniscal suturing on a standardized lesion using either a traditional or continuous arthroscopic suturing technique.
METHODS
A preclinical study was carried out with 21 medical doctors who underwent training in the 2 modalities of meniscal repair by arthroscopy in an animal model laboratory. Participants performed both types of sutures with a previously standardized lesion. The execution time of the techniques was measured, and an experienced surgeon evaluated the stability of a meniscal tear after the repair. Data were analyzed using a test for paired samples to calculate the difference between the execution times of the techniques.
RESULTS
The time required to perform the continuous meniscal suture was shorter than that of the traditional suture. After statistical analysis, the time difference between the techniques was significant (mean difference 4:17 ± 5:30 minutes; 95% confidence interval, 1:46-6:46 minutes). Surgeons took less time than residents for the traditional suture ( = .036), but the times were similar for the continuous suture. This suggests that experience level has a greater effect on the time needed for the traditional suture than for the continuous suture.
CONCLUSIONS
The continuous suture technique was performed in a shorter time compared with the traditional suture technique in a porcine model.
CLINICAL RELEVANCE
The results of this preclinical study suggest that the continuous vertical inside-out meniscal suture technique can enhance surgical procedures for longitudinal tears requiring ≥4 stitches, offering a faster and more intuitive learning curve compared with the traditional inside-out suture technique.
目的
比较使用传统或连续关节镜缝合技术对标准化损伤进行半月板缝合所用的时间。
方法
在动物模型实验室对21名接受过关节镜下半月板修复两种方式培训的医生进行了一项临床前研究。参与者对先前标准化的损伤进行两种类型的缝合。测量技术的执行时间,并且由一名经验丰富的外科医生评估修复后半月板撕裂的稳定性。使用配对样本检验分析数据以计算技术执行时间之间的差异。
结果
进行连续半月板缝合所需的时间比传统缝合短。经过统计分析,两种技术之间的时间差异显著(平均差异4:17 ± 5:30分钟;95%置信区间,1:46 - 6:46分钟)。对于传统缝合,外科医生比住院医生花费的时间少(P = .036),但连续缝合的时间相似。这表明经验水平对传统缝合所需时间的影响大于对连续缝合所需时间的影响。
结论
在猪模型中,与传统缝合技术相比,连续缝合技术的操作时间更短。
临床意义
这项临床前研究的结果表明,连续垂直由内向外半月板缝合技术可以改进对需要≥4针缝合的纵向撕裂的手术操作,与传统的由内向外缝合技术相比,提供了更快且更直观的学习曲线。