关节镜下半月板缝合技巧

目的 :总结 3 0 8例膝关节半月板缝合的技巧和经验。方法 :根据 3 0 8例关节镜下半月板缝合的临床实践 ,归纳半月板修复的基本操作程序和该项技术的操作技巧。根据缝合修复的特点进行半月板损伤部位的分区。结果 :3 0 8例半月板缝合全部在镜下完成 ,无 1例改用切开操作 ,其中缝合 2针 1 96例 ,4针 96例 ,6针 1 2例 ,8针 3例 ,1 2针 1例。操作中出现的问题有 :缝线打结断裂 8例 ,缝线拽脱 4例 ,缝合针弯曲 5例。缝合时间 3 0～ 90分钟 ,平均 60分钟 ,其中以Ⅱ区缝合时间最短 ,平均 40分钟 ;Ⅰ区 (前角区 )、Ⅳ区 (后角区 )最长 ,平均 65分钟。全部病例经 6个月～76个月随访 (平均 2 6个月) ,膝关节无症状率达 92 %。Lysholm评分 :术前 5 2±1 1 ,术后 92± 8(P <0 0 1 )。结论 :关节镜下半月板缝合术是治疗半月板损伤有效的手段之一

Study on Arthroscopic Technique of Meniscus Suture

Objective To summarize the application of arthroscopic technique of meniscus suture. Methods Three hundreds and eight patients with meniscus tear were treated under arthroscopy. Meniscus was divided into 4 parts in this study according to the features of operation. Results: Among 308 patients, 2 sutures were performed in 196 patients; 4 sutures in 96 patients; 6 sutures in 12 patients; 8 sutures in 4 patients and 12 sutures in 1 patient. The difficulty of operation included broken suture in 8 patients, pulling out of suture in 4 patients and bending of needle in 5 patients. Duration of suture procedure was 60 minutes averagely (from 30 minutes to 90 minutes). All patients were followed up from 6 months to 76 months with average of 26 months. Asymptomatic rate of knee joint was 92% postoperatively. Lysholm scale score were 52±11 before operation and 92±8 during follow up( P < 0.01). Conclusions Meniscus tear can be well treated using arthroscopic technique. The experience from our clinical practice proved that the technique could be easier to popularize.