CAJ | 학술논문

目的探讨关节镜下联合修补技术治疗内侧半月板桶柄样撕裂的临床疗效.方法采用关节镜下联合修补技术修补20例(20个)内侧半月板桶柄样撕裂,均累及内侧半月板后角至前体部区域.半月板体部和前角采用标准的自内向外缝合;半月板后角采用全关节内缝合:经两个后内侧入路在关节内完成垂直褥式缝合.单纯的红-白交界处撕裂修补后局部植入血凝块促进愈合,合并前十字韧带损伤者同时行韧带重建手术.结果 20例患者均得到随访,随访时间5～36(19.2±2.3)个月.其中无症状18例,关节间隙压痛2例.20个半月板经MRI复查,完全愈合15个,部分愈合5个.术后膝关节功能Lysholm评分82～97(90.3±1.5)分,与术前的45～69(56.7±2.0)分比较差异有统计学意义(P=0.024).结论对于发生在红-红或红-白交界处的内侧半月板桶柄样撕裂,关节镜下联合修补技术是安全、可靠的方法.
목적 탐토관절경하연합수보기술치료내측반월판통병양시렬적림상료효.방법 채용관절경하연합수보기술수보20례(20개)내측반월판통병양시렬,균루급내측반월판후각지전체부구역.반월판체부화전각채용표준적자내향외봉합;반월판후각채용전관절내봉합:경량개후내측입로재관절내완성수직욕식봉합.단순적홍-백교계처시렬수보후국부식입혈응괴촉진유합,합병전십자인대손상자동시행인대중건수술.결과 20례환자균득도수방,수방시간5～36(19.2±2.3)개월.기중무증상18례,관절간극압통2례.20개반월판경MRI복사,완전유합15개,부분유합5개.술후슬관절공능Lysholm평분82～97(90.3±1.5)분,여술전적45～69(56.7±2.0)분비교차이유통계학의의(P=0.024).결론 대우발생재홍-홍혹홍-백교계처적내측반월판통병양시렬,관절경하연합수보기술시안전、가고적방법.
Objective To investigate the arthroscopic inside-out repairing technique(hybrid suture technique) for bucket-handle tear of inside meniscus and present the short-term clinical outcome. Methods Twenty patients with 20 repairable inside meniscus tears were enrolled. With arthroscopic technique,the midbody portion and anterior portion of the lesion were repaired using standard inside-out technique with vertical and interlacing tibial and femoral side arrangement. For the most posterior portion, all-inside suture technique with two posterior portals were performed. For isolated red-white zone tears,fibrin clot was implanted into the repaired region for enhancing the healing pro-ACL injuries were reconstructed simultaneously. Results Twenty patients with 20 meniscal repairs were available for 5-36 (19.2 ± 2.3)months follow-up. Eighteen cases were asymptomatic at the latest clinical evaluation,and joint space tenderness in 2 cases. Twenty cases received MRI evaluation during follow-up, showing that 15 menisci were completely healed, 5 partially healed. Postoperative Lysholm scores of the knee joint function [82-97(90.3 ±1.5) points] were significantly improved compared with their preoperative scores [45-69 (56.7 ± 2.0)points] (P = 0.024).Conclusion For meniscal tears involving red-red and red-white zones,arthroscopic hybrid suture technique provides stable strength along the whole length of injured region, and consequently achieves satisfactory clinical outcomes.