Nishino Kazuya, Hashimoto Yusuke, Tsumoto Shuko, Iida Ken, Kinoshita Takuya, Nakamura Hiroaki
Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Arthrosc Tech. 2024 Jun 21;13(11):103095. doi: 10.1016/j.eats.2024.103095. eCollection 2024 Nov.
An incomplete discoid lateral meniscus is often associated with radial tears, which cause meniscal extrusion and result in poor healing outcomes. Centralization has recently been used as a surgical method to reduce extrusion. However, various repair techniques use single point of fixation sutures exclusively on the femoral side, potentially hindering healing. In this study, a method is devised in which 2 anchor sutures are placed on the tibia and guided out of the capsule from the tibial side of the meniscus, and another anchor is placed distally to tighten the meniscotibial ligament in a plane. This method supports the repaired site against hoop stress by tightening the meniscotibial ligament and is considered a physiological repair because the sutures are confirmed to the tibial side of the meniscus rather than on the femoral side. Furthermore, an inside-out suture of the torn area with a fibrin clot derived from the bone marrow aspirate, rich in tissue-healing components, is also performed.
不完全盘状外侧半月板常与放射状撕裂相关，这会导致半月板挤出并导致愈合效果不佳。最近，中心化已被用作一种减少挤出的手术方法。然而，各种修复技术仅在股骨侧使用单点固定缝线，这可能会阻碍愈合。在本研究中，设计了一种方法，即在胫骨上放置2根锚定缝线，并从半月板的胫骨侧引出关节囊，在远端放置另一个锚定物以在平面内收紧半月板胫骨韧带。该方法通过收紧半月板胫骨韧带为修复部位提供抗环向应力的支撑，并且由于缝线固定在半月板的胫骨侧而非股骨侧，因此被认为是一种生理性修复。此外，还对撕裂区域进行了由富含组织愈合成分的骨髓抽吸物衍生的纤维蛋白凝块的由内向外缝合。
