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一种在全膝关节置换术中使用聚二氧六环酮(PDS II)进行关节囊闭合的改良缝合技术:一项与传统缝合技术比较的前瞻性随机研究。

A modified suture technique using polydioxanone (PDS II) for capsule closure in total knee arthroplasty: a prospective randomized study compared with traditional suture technique.

作者信息

Zhang Caidong, Tang Jing, Deng Jiayan, Luo Xiaozhong, Wu Chao, Zhang Tongzheng, Xiang Weishi, Wu Gang

机构信息

Department of Orthopedics, Zigong Fourth People's Hospital, Zigong, 643000, Sichuan, People's Republic of China.

Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Fourth Clinical College of Peking University, No.31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China.

出版信息

Arch Orthop Trauma Surg. 2025 Jan 7;145(1):116. doi: 10.1007/s00402-024-05677-9.

Abstract

PURPOSE

To describe and evaluate the modified suture technique using PDS II for capsule closure in Total knee arthroplasty.

METHODS

One hundred-five patients with end-stage osteoarthritis of the knee received Total knee arthroplasty (TKA) in our department. The arthrotomy wounds were closed randomly utilizing either modified suture (the MS group, 53 patients) or traditional suture (the TS group, 52 patients) techniques. The time of suturing, rupture of the suture, water tightness, wound seepage and the days of hospitalization were recorded and compared between the two groups. Complications such as infection and rejection of the wound were also assessed.

RESULTS

Records indicated significantly shorter time of suturing for the capsule in the MS group (4.6 ± 0.6 min) than in the TS group (16.8 ± 1.1 min, P < 0.001). The mean time of hospitalization was also significantly shorter in the MS group (7.8 + 1.8d) than in the TS group (13.1 + 2.7d, P < 0.001).There were 51 cases in MS group and 42 cases in TS group showed good tightness, the rate of tightness in the MS group (51/53) was significantly higher than in the TS group (42/52, P = 0.015).The rate of postoperative wound seepage in the MS group (3/53) was significantly lower than in the TS group (11/52, P = 0.023). The rate of rupture of the suture in the MS group (0/53) showed no significantly difference compared with the TS group (3/52, P = 0.118). There were no complications such as infection and rejection occurred in both groups.

CONCLUSION

The modified suture technique using PDS II appears to be a promising option for the capsule closure in TKA because it was associated with shorter surgical time, better water tightness, fewer wound see-page, shorter of hospitalization and relatively fewer complications.

摘要

目的

描述并评估在全膝关节置换术中使用聚对二氧环己酮(PDS II)缝线进行改良缝合技术来闭合关节囊。

方法

105例终末期膝骨关节炎患者在我科接受全膝关节置换术(TKA)。关节切开伤口随机采用改良缝合(MS组,53例患者)或传统缝合(TS组,52例患者)技术进行闭合。记录并比较两组的缝合时间、缝线断裂情况、水密性、伤口渗液及住院天数。还评估了感染和伤口排斥等并发症。

结果

记录显示MS组关节囊缝合时间(4.6±0.6分钟)明显短于TS组(16.8±1.1分钟,P<0.001)。MS组平均住院时间(7.8±1.8天)也明显短于TS组(13.1±2.7天,P<0.001)。MS组有51例、TS组有42例显示密封性良好,MS组的密封性率(51/53)明显高于TS组(42/52,P = 0.015)。MS组术后伤口渗液率(3/53)明显低于TS组(11/52,P = 0.023)。MS组缝线断裂率(0/53)与TS组(3/52,P = 0.118)相比无显著差异。两组均未发生感染和排斥等并发症。

结论

使用PDS II的改良缝合技术似乎是全膝关节置换术中闭合关节囊的一个有前景的选择,因为它与手术时间短、水密性好、伤口渗液少、住院时间短及并发症相对较少相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0b6/11706840/0aef0c8cc8c3/402_2024_5677_Fig1_HTML.jpg

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