Nakayama Hiroshi, Kanto Ryo, Onishi Shintaro, Yoshiya Shinichi, Tachibana Toshiya, Iseki Tomoya
Department of Orthopaedic Surgery, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo, Japan.
Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Hyogo, Japan.
Arthrosc Tech. 2024 Dec 5;14(4):103353. doi: 10.1016/j.eats.2024.103353. eCollection 2025 Apr.
In recent years, degenerative meniscal lesions have received increasing attention as an etiological factor in the development and progression of knee osteoarthritis. Among various features associated with meniscal degeneration, meniscal extrusion is considered to be a significant morphologic factor affecting meniscal function. On the basis of the close association between medial meniscal extrusion and osteoarthritic progression reported in literature, surgical reduction of the extruded medial meniscus by means of arthroscopic centralization or capsulodesis has been proposed to restore meniscal function, with favourable outcomes reported. On the lateral side of the knee, meniscal extrusion may also be associated with various meniscal lesions, such as degenerative, radial, posterior root, and discoid meniscal tears, or present as a complication after partial meniscectomy or meniscal transplantation. This article describes the rationale and procedure for arthroscopic belt capsulodesis using two knotless anchors in order to reduce lateral meniscus extrusion. The procedure described in this technical note is technically simple and can effectively reduce the meniscal extrusion by reattaching and tightening the capsule, thereby restoring meniscal function.
近年来,作为膝关节骨关节炎发生和发展的一个病因,半月板退行性病变日益受到关注。在与半月板退变相关的各种特征中,半月板挤出被认为是影响半月板功能的一个重要形态学因素。基于文献报道的内侧半月板挤出与骨关节炎进展之间的密切关联,有人提出通过关节镜下半月板复位或关节囊固定术对挤出的内侧半月板进行手术复位,以恢复半月板功能,且已报道了良好的效果。在膝关节外侧,半月板挤出也可能与各种半月板病变相关,如退行性、放射状、后根部和盘状半月板撕裂,或表现为部分半月板切除术或半月板移植术后的并发症。本文介绍了使用两个无结锚钉进行关节镜下带状关节囊固定术以减少外侧半月板挤出的原理和操作步骤。本技术说明中描述的操作在技术上简单易行,通过重新附着和收紧关节囊可有效减少半月板挤出,从而恢复半月板功能。