[1]吴美平 刘清高△ 李光富 华贤章 陈淑.关节镜下穿刺针改良缝合技术治疗半月板撕裂的临床疗效[J].中国中医骨伤科杂志,2022,30(05):68-72.
 WU Meiping LIU Qinggao LI Guangfu HUA Xianzhang CHEN Shu.Clinical Efficacy of Improved Puncture Needle Suture Techniqueunder Arthroscopic on the Treatment of Meniscus Tear[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(05):68-72.
点击复制

关节镜下穿刺针改良缝合技术治疗半月板撕裂的临床疗效()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年05期
页码:
68-72
栏目:
临床报道
出版日期:
2022-05-15

文章信息/Info

Title:
Clinical Efficacy of Improved Puncture Needle Suture Techniqueunder Arthroscopic on the Treatment of Meniscus Tear
文章编号:
1005-0205(2022)05-0068-05
作者:
吴美平1 刘清高2△ 李光富1 华贤章1 陈淑1
1恩施土家族苗族自治州中心医院骨伤科(湖北 恩施,445000)
2湖北民族大学附属民大医院关节外科
Author(s):
WU Meiping1 LIU Qinggao2△ LI Guangfu1 HUA Xianzhang1 CHEN Shu1
1Department of Orthopedics and Traumatology,Enshi Tujia and Miao Autonomous Prefecture Central Hospital,Enshi 445000,Hubei China; 2Department of Joint Surgery,Renmin University Hospital Affiliated to Hubei University for Nationalities,Enshi 445000,Hubei China.
关键词:
穿刺针半月板撕裂缝合技术膝关节
Keywords:
puncture needle meniscus tear suture knee
分类号:
R687.4
文献标志码:
B
摘要:
目的:探讨关节镜下穿刺针改良缝合和Fast-Fix 全内缝合技术在修复半月板撕裂患者中的临床效果。方法:回顾性分析2017年10月至2019年12月采用缝合技术修复半月板前角及体部损伤患者91例,纳入穿刺针改良缝合组患者47例,Fast-Fix 组患者44例,记录患者术中有无神经血管损伤、术后有无感染及排异反应。记录临床结局指标:平均每针缝合时长、半月板术中修复失效率、术后修复失效率。并记录膝关节功能Lysholm 评分和Tegner 活动评级。术后12个月复查MRI,观察半月板愈合情况。结果:两组患者术中未出现神经血管损伤,术后未出现伤口感染及内固定排异反应,末次门诊随访时关节疼痛较术前明显改善,未出现关节绞锁及关节肿胀等; 术中每针缝合时长比较差异有统计学意义(P<0.001),两组术中失效率、术后失效率比较差异无统计学意义(P>0.05)。末次随访时,术后失效并需再次手术的患者在穿刺针改良缝合组中有5例(11.36%), Fast-Fix 组有6例(13.63%)。两组患者术前、术后12个月及末次随访时Lysholm 评分和Tegner 活动评级比较差异无统计学意义(P>0.05); 术后12个月复查患膝MRI示半月板愈合情况可。结论:采用关节镜下穿刺针改良缝合临床疗效肯定,并且术中无需特殊器械,操作简易,值得临床推广应用。
Abstract:
To investigate the clinical efficacy of modified puncture needle suture under arthroscopic and Fast-Fix total internal suture in repairing meniscus tear.Methods:A total of 91 patients with meniscus anterior horn and body injury repaired by suture were retrospectively analyzed.47 patients were included in the modified puncture and suture group and 44 patients in the Fast-Fix group.Intraoperative neurovascular injuries,postoperative infections and rejection were recorded.The clinical outcome indexes including surgical average suture time per needle,intraoperative failure rate of meniscus repair and postoperative repair failure rate were recorded.Additionally,Lysholm score and Tegner activity rating of knee function were recorded.The healing situation of the meniscus was observed by MRI 12 months after surgery.Results:No intraoperative neurovascular injury,postoperative wound infection or fixed rejection occurred in the two groups.At the last outpatient follow-up,the joint pain was significantly improved compared with that before surgery,without interlocking or swelling joints.Surgical intraoperative suture time per needle showed statistically significant differences between the two groups(P<0.001).However,no statistically significant differences was found in intraoperative or postoperative failure rate between the two groups(P>0.05).At the last follow-up,there were 5(11.36%)patients in the modified outside-in puncture and suture group and 6(13.63%)patients in the Fast-Fix group with postoperative failure and needing secondary surgery.Lysholm score and Tegner activity rating presented no statistically significant differences between the two groups before surgery,12 months after surgery and at the last follow-up(P>0.05).The knee MRI 12 months after surgery displayed that the healing of the meniscus was satisfactory.Conclusion:The modified arthroscopic puncture needle suture presents good clinical efficacy,and it needs no special instruments during surgery and simple operation.Therefore,it is worthy of clinical promotion.

参考文献/References:

[1] STEINER S,FEELEY S M,RULAND J R,et al.Outside-in repair technique for a complete radial tear of the lateral meniscus[J].Arthrose Tech,2018,7(3):e285-e288.
[2] 刘中砥,许庭珉.关节镜下改良outside-in穿刺缝合技术修复半月板撕裂的中期临床随访[J].北京大学学报(医学版),2020,52(5):870-874.
[3] TWOMEY-KOZAK J,JAYASUFIYA C T.Meniscus repair and regeneration:a systematic review from a basic and translational science perspective[J].Clin Sports Med,2020,39(1):125-163.
[4] OATES K M.Editorial commentary:all-inside meniscal repair devices:should we cease and de-cyst[J].Arthroscopy:The Journal of Arthroscopy & Related Surgery,2019,35(4):1230-1231.
[5] MUNIANDY M,RAJAGOPAL S,TAHIR S H.Arthroscopic all-inside repair of tear of the anterior horn of discoid lateral meniscus[J].Surg J(N Y),2019,5(1):e35-e37.
[6] 史加奎.关节镜下outside-in缝合技术与腰椎穿刺针关节内过线缝合技术修复半月板前角撕裂的临床比较[J].现代诊断与治疗,2019,30(17):3060-3061.
[7] JENKINS J M.All-inside arthroscopic meniscal repair with the arthrex meniscal cinch Ⅱ[J].Surgical Technology International,2020,36:331-334.
[8] KMIA M,GHALY Y,A1-HADITHY N,et al.Cmtent concepts in the techniques,indications and outcomes of meniscal repairs[J].Eur J Orthop Surg Tranmatol,2019,29(3):509-520.
[9] 李永忠,喻璐.关节镜下Fast-Fix缝合半月板损伤的疗效观察[J].中国中医骨伤科杂志,2017,25(5):59-63.
[10] 毛云鹤,孙伟豪.关节镜下穿刺针改良缝合修复技术在治疗半月板纵行撕裂伤病例中的对照观察[J].中国骨伤,2021,34(2):114-120.
[11] HIRANAKA T,FURUMATSU T,MIYAZAWA S,et al.Comparison of the clinical outcomes of transtibial pull-out repair for medial meniscus posterior root tear:two simple stitches VeFSUS modified mason-allen suture[J].Knee,2020,27(3):701-708.
[12] WANG Z Q,XIONG Y,TANG X,et al.An arthroseopie repair technique for meniseal tear using a needle and suture:outside-in transfer allinside repair[J].BMC Musculoskelet Disord,2019,20(1):614.
[13] 王旭,马娟娟,刘俊雄,等.纤维血凝块填塞联合关节镜下Fast-FIX修复半月板撕裂的愈合相关因素分析[J].中国中医骨伤科杂志,2018,26(11):58-61.
[14] KANTO R,YAMAGUEHI M,SASAKI K.et al.Second-lock arthroscopic evaluations of meniscal repairs associated with anterior cruciate ligament reconstruction[J].Arthroscopy,2019,35(10):2868-2877.
[15] 周星,袁湘尧.关节镜下自外向内技术缝合治疗半月板损伤[J].临床骨科杂志,2021,24(1):78.

备注/Memo

备注/Memo:
通信作者 E-mail:63663645@qq.com
更新日期/Last Update: 1900-01-01