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经关节镜入路与经胫骨隧道联合使用硬膜外针进行后半月板根部修复

Posterior Meniscal Root Repair with Epidural Needle through the Combination of Arthroscopic Portals and Transtibial Tunnel.

作者信息

Nakahashi Eiji Rafael, Lemes Igor Leal Clemente, Albano Mauro Batista, Stieven Filho Edmar, Namba Mario Massatomo, Nunes Carolline Popovicz

机构信息

Grupo de Cirurgia do Joelho e Trauma do Esporte, Complexo Hospital do Trabalhador, Universidade Federal do Paraná, Curitiba, PR, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Dec 21;59(6):e997-e1002. doi: 10.1055/s-0044-1790214. eCollection 2024 Dec.

DOI:10.1055/s-0044-1790214
PMID:39711645
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11663058/
Abstract

Posterior meniscal root repair is an expensive procedure because its performance often requires the use of specific devices. This issue is a limiting factor, especially in the public health system. Given this context, the development of alternative methods to treat these injuries became necessary. Among the available options, the technique combining the use of anterior portals and a tibial bone tunnel with an epidural needle has been proven to be effective and relevant due to its low cost. The present study aimed to provide technical guidance and suggestions to increase the success rate of this procedure, to enable its performance by knee surgeons in low-resource settings.

摘要

后半月板根部修复是一种昂贵的手术，因为其实施通常需要使用特定的器械。这个问题是一个限制因素，尤其是在公共卫生系统中。鉴于这种情况，开发治疗这些损伤的替代方法变得必要。在现有的选择中，将前外侧入路和带硬膜外穿刺针的胫骨骨隧道相结合的技术因其成本低而被证明是有效且实用的。本研究旨在提供技术指导和建议，以提高该手术的成功率，使资源匮乏地区的膝关节外科医生能够开展该手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/989e5430d543/10-1055-s-0044-1790214-i2300250pt-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/0dc845c0cd23/10-1055-s-0044-1790214-i2300250en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/65f2f63c466c/10-1055-s-0044-1790214-i2300250en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/7b84b5016a67/10-1055-s-0044-1790214-i2300250en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/9441c07c0a79/10-1055-s-0044-1790214-i2300250en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/f5ab79179c84/10-1055-s-0044-1790214-i2300250en-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/e3c74d18dfe7/10-1055-s-0044-1790214-i2300250pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/6a96975b9e4d/10-1055-s-0044-1790214-i2300250pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/242ef8a5b2ac/10-1055-s-0044-1790214-i2300250pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/95c85da05957/10-1055-s-0044-1790214-i2300250pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/989e5430d543/10-1055-s-0044-1790214-i2300250pt-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/0dc845c0cd23/10-1055-s-0044-1790214-i2300250en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/65f2f63c466c/10-1055-s-0044-1790214-i2300250en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/7b84b5016a67/10-1055-s-0044-1790214-i2300250en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/9441c07c0a79/10-1055-s-0044-1790214-i2300250en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/f5ab79179c84/10-1055-s-0044-1790214-i2300250en-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/e3c74d18dfe7/10-1055-s-0044-1790214-i2300250pt-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/6a96975b9e4d/10-1055-s-0044-1790214-i2300250pt-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/242ef8a5b2ac/10-1055-s-0044-1790214-i2300250pt-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/95c85da05957/10-1055-s-0044-1790214-i2300250pt-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b66/11663058/989e5430d543/10-1055-s-0044-1790214-i2300250pt-5.jpg

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本文引用的文献

1
Alternative Techniques for Lateral and Medial Posterior Root Meniscus Repair Without Special Instruments.无需特殊器械的内外侧后根半月板修复替代技术
Arthrosc Tech. 2020 Jun 27;9(7):e1017-e1025. doi: 10.1016/j.eats.2020.03.023. eCollection 2020 Jul.
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Meniscal Root Tears: Current Concepts Review.半月板根部撕裂：当前概念综述
Arch Bone Jt Surg. 2018 Jul;6(4):250-259.
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Understanding posterior meniscal roots lesions: from basic science to treatment.了解后交叉韧带半月板根部损伤：从基础科学到治疗
Rev Bras Ortop. 2017 Jul 26;52(4):463-472. doi: 10.1016/j.rboe.2017.07.005. eCollection 2017 Jun-Jul.
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Evaluation, Treatment, and Outcomes of Meniscal Root Tears: A Critical Analysis Review.半月板根部撕裂的评估、治疗及结果：一项批判性分析综述
JBJS Rev. 2016 Aug 9;4(8). doi: 10.2106/JBJS.RVW.15.00082.
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Tibiofemoral contact mechanics following posterior root of medial meniscus tear, repair, meniscectomy, and allograft transplantation.内侧半月板后根部撕裂、修复、半月板切除术和同种异体移植术后的胫股接触力学。
Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2121-5. doi: 10.1007/s00167-012-2182-4. Epub 2012 Sep 7.
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Predictors of degenerative medial meniscus extrusion: radial component and knee osteoarthritis.预测内侧半月板退行性外突的因素：放射学成分和膝关节骨关节炎。
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