Tian Xinduo, Miao Yi, Liu Xin, Wang Wei, Liu Na, Zhang Xuesong
The Second Department of Joint Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China.
The First Department of Joint Surgery, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 May 15;39(5):550-555. doi: 10.7507/1002-1892.202502044.
To explore the effectiveness of arthroscopic All-inside single needle vertical suture technique in treatment of complete radial tear of the meniscus.
Between January 2019 and January 2022, 18 patients (18 knees) with complete radial tear of the meniscus were treated by using arthroscopic All-inside single needle vertical suture technique. Among them, there were 12 males and 6 females with an average age of 37.1 years (range, 16-50 years). The causes of radial meniscus tears included the sports injuries in 11 cases, sprains/falls in 4 cases, and traffic accident injuries in 3 cases. The interval between injury and operation was 3-25 days (mean, 11.7 days). All patients had knee joint pain. Knee joint tenderness and McMurray sign were both positive. MRI showed the 15 cases of lateral meniscus tear and 3 cases of medial meniscus tear; 15 cases of anterior cruciate ligament injury, 1 case of posterior cruciate ligament injury, and 15 cases of tibial plateau bone contusion. Six patients underwent isolated meniscus repair and 12 patients with cruciate ligament rupture underwent meniscus repair and simultaneous cruciate ligament reconstruction. The operation time and incidence of postoperative complications were recorded. At last follow-up, the meniscus healing was evaluated according to Barrett's criteria and knee joint MRI, respectively. Lysholm score and International Knee Documentation Committee (IKDC) score were used to evaluate the functional recovery of the knee joint.
The operation time was 19-28 minutes (mean, 23.3 minutes) in 6 patients with isolated meniscus repair and 38-52 minutes (mean, 45.8 minutes) in 12 patients with meniscus repair and simultaneous cruciate ligament reconstruction. All incisions healed by first intention. After operation, 1 patient developed the deep vein thrombosis of lower limb, the other patients had no complication. All patients were followed up 12-18 months (mean, 15.2 months). At last follow-up, 16 cases of meniscus reached clinical healing according to Barrett's criteria, with a healing rate of 88.9%. MRI re-examination of the knee joint showed that 5 cases had complete healing of the meniscus, 11 cases had partial healing, and 2 cases did not heal. The total healing rate (complete healing and partial healing) was 88.9%. After operation, the Lysholm score and IKDC score of 18 patients increased compared to preoperative scores, and further improved with time. The differences between different time points were significant ( <0.05). Six patients with isolated meniscus repair had the same changes in the above scores, and the differences between the different time points were significant ( <0.05).
The arthroscopic All-inside single needle vertical suture technique can achieve good short-term effectiveness in the treatment of complete radial tears of the meniscus.
探讨关节镜下全内置单针垂直缝合技术治疗半月板完全放射状撕裂的有效性。
2019年1月至2022年1月，采用关节镜下全内置单针垂直缝合技术治疗18例（18膝）半月板完全放射状撕裂患者。其中男性12例，女性6例，平均年龄37.1岁（16 - 50岁）。半月板放射状撕裂的原因包括运动损伤11例、扭伤/跌倒4例、交通事故伤3例。受伤至手术间隔时间为3 - 25天（平均11.7天）。所有患者均有膝关节疼痛。膝关节压痛和麦氏征均为阳性。MRI显示外侧半月板撕裂15例，内侧半月板撕裂3例；前交叉韧带损伤15例，后交叉韧带损伤1例，胫骨平台骨挫伤15例。6例患者单纯行半月板修复，12例合并交叉韧带断裂患者行半月板修复同时行交叉韧带重建。记录手术时间及术后并发症发生率。末次随访时，分别根据巴雷特标准和膝关节MRI评估半月板愈合情况。采用Lysholm评分和国际膝关节文献委员会（IKDC）评分评估膝关节功能恢复情况。
单纯半月板修复的6例患者手术时间为19 - 28分钟（平均23.3分钟），半月板修复同时行交叉韧带重建的12例患者手术时间为38 - 52分钟（平均45.8分钟）。所有切口均一期愈合。术后1例患者发生下肢深静脉血栓形成，其余患者无并发症。所有患者随访12 - 18个月（平均15.2个月）。末次随访时，根据巴雷特标准，16例半月板达到临床愈合，愈合率为88.9%。膝关节MRI复查显示半月板完全愈合5例，部分愈合11例，未愈合2例。总愈合率（完全愈合和部分愈合）为88.9%。术后18例患者的Lysholm评分和IKDC评分均较术前升高，并随时间进一步改善。不同时间点差异有统计学意义（<0.05）。单纯半月板修复的6例患者上述评分变化相同，不同时间点差异有统计学意义（<0.05）。
关节镜下全内置单针垂直缝合技术治疗半月板完全放射状撕裂可取得良好的短期疗效。
