关节镜下全内缝合法修补内侧半月板后角损伤

目的:探讨内侧半月板后角损伤的关节镜下全内修补方法及其临床疗效。方法:自2002年4月~2005年4月间在本院进行前交叉韧带损伤合并内侧半月板后角损伤治疗的患者89例。对其中85例患者应用全内缝合方法手术,经两个后内入路配合髁间窝入路,利用缝合钩修补损伤半月板;同时选择绳肌腱、自体或异体骨-腱-骨移植物重建受损前交叉韧带。结果:可随访者75例(84·3%),随访5~41个月,平均20·2个月。随访采用主观症状检查、临床查体、2次关节镜手术复查(25例)及MRI复查(21例)等。随访到的75例患者的主观症状及临床查体结果均正常,其中25例患者经2次关节镜手术复查结果均为全部愈合;经MRI复查的21例患者中,18例完全愈合,3例部分愈合。结论:关节镜下全内缝合方法是修补内侧半月板后角损伤的理想方法,术后疗效好。

Arthroscopic All-inside Suture Technique for Repairing Medial Meniscus Posterior Horn Tear

Objective To present the special arthroscopic all-inside suture technique for repairing medial meniscus posterior horn tears and clinical follow-up results including arthroscopy and MRI outcome. Methods Eighty nine cases of posterior horn tears of medial meniscus combining with anterior cruciate ligament injuries were enrolled in this setting.Arthroscopic all-inside suturing medial meniscus through 2 posteromedial portals and 1 transcondylar portal was performed, with simultaneous ACL reconstruction using hamstring or B-PT-B autograft or allograft. Results Seventy five cases(84.3%)were followed-up for an average of 20.2 months, in which 25 cases underwent arthroscopic evaluation and 21 MRI evaluation.All 25 cases undergoing second-look arthroscopies were completely healed.Of the 21 cases receiving MRI evaluation, 18 were completely healed and 3 were partialy healed. Conclusions Arthroscopic all-inside suture technique is a good alternative for repairing medial meniscus posterior horn tear and a higher healing rate can be obtained using such a technique.