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
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作者Author单位AddressE-Mail
毛云鹤 MAO Yun-he 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
孙伟豪 SUN Wei-hao 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
熊燕 XIONG Yan 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
陈刚 CHEN Gang 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
李棋 LI Qi 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
唐新 TANG Xin 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
付维力 FU Wei-li 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China  
李箭 LI Jian 四川大学华西医院骨科, 四川 成都 610041 Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China hxlijian.china@163.com 
期刊信息:《中国骨伤》2021年,第34卷,第2期,第114-120页
DOI:10.12200/j.issn.1003-0034.2021.02.004
基金项目:
中文摘要:

目的:比较关节镜下穿刺针改良缝合技术和Fast-Fix全内技术在缝合修复半月板纵行撕裂患者中的治疗效果。

方法:回顾性研究2016年7月至2017年7月行半月板缝合修复手术的半月板纵行撕裂患者,穿刺针改良缝合组91例,Fast-Fix组77例。两组患者年龄分别为(26.7±7.6)岁与(27.9±6.1)岁,随访时间分别为(32.5±9.2)个月与(33.2±11.9)个月。采用手术费用、平均缝合时长、术中修复失效率以及术后修复失效率作为临床结局指标,其中以膝关节MRI检查作为主要诊断和评价依据。术前、术后12个月及末次随访时两组均采用2000IKDC主观评分、Lysholm评分以及Tegner活动评级作为膝关节功能评价指标,同时记录所有患者术中及术后出现并发症情况。

结果:穿刺针改良缝合组患者较FasT-Fix组患者有更低的手术费用[(645.7±133.1)元vs. (12 184.8±4 709.8)元,P<0.01];且平均每针的缝合时间更短[(4.5±2.1)min vs. (5.9±2.7)min,P<0.001]。两组患者的术中修复失效率与术后修复失效率比较差异无统计学意义(P>0.05)。两组患者在术后12个月以及末次随访时的各项患者主观功能Lysholm评分,Tegner活动评级方面评分比较差异均无统计学意义(P>0.05)。两组患者末次随访各项功能评分均较术前明显提升(P<0.000 1)。

结论:采用穿刺针改良缝合技术缝合修复半月板能获得与Fast-Fix相当的治疗效果,且手术操作更为简便,卫生经济学收益更高,本研究推荐关节镜下穿刺针改良缝合修复技术在治疗半月板损伤方面的临床应用。
【关键词】半月板  创伤与损伤  缝合技术  膝关节
 
Modified single-needle arthroscopic repair technique for the treatment of longitudinal meniscal tear
ABSTRACT  

Objective: To compare therapeutic efficacy of modified single-needle arthroscopic repair technique and Fast-Fix technique in repairing longitudinal meniscus injuries.

Methods: From July 2016 to July 2017,patients with longitudinal meniscus injuries who underwent meniscal repair surgery were retrospectively analyzed. Ninety-one patients treated with modified single-needle technique and 77 patients were treated with Fast-Fix technique,the average age were (26.7±7.6) and (27.9±6.1) years old respectively,the average lengths of follow-up were (32.5±9.2) and (33.2±11.9) months,respectively. Operation cost,suture time,intraoperative failure rate and postoperative failure rate were used as clinical outcomes,MRI of knee joint was used as main diagnosis and evaluation basis; 2000 IKDC subjective score,Lysholm score and Tegner activity scale were compared between two groups preoperatively,12 months after operation and at the latest follow-up. Intraoperative and postopertaive complications were observed.

Results: Compared with Fast-Fix group,patients in modified single-needle technique group had lower operation costs[(645.7±133.1 vs.(12 184.8±4 709.8),P<0.01)],and average time per suture was shorter[(4.5±2.1) vs.(5.9±2.7),P<0.001)];and there were no significant difference in intraoperative failure rate and postoperative failure rate between two groups. There were no statistical differences in subjective function score,Lysholm score,Tegner activity knee joint at 12 months after opertaion and the latest follow-up(P>0.05);These scores between two groups at the latest followup were significantly improved compared with those of before operation(P<0.000 1).

Conclusion: Modified single-needle arthrscopic repair technique could achieve the similar therapeutic efficacy as Fast-Fix technique,and it has advantageds of simple opertion and more economical. This study recommends clinical application of modified single-needle arthrscopic repair technique in treating meniscus injuries.
KEY WORDS  Meniscus  Wound and injuries  Suture techniques  Knee joint
 
引用本文,请按以下格式著录参考文献:
中文格式:毛云鹤,孙伟豪,熊燕,陈刚,李棋,唐新,付维力,李箭.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
英文格式:MAO Yun-he,SUN Wei-hao,XIONG Yan,CHEN Gang,LI Qi,TANG Xin,FU Wei-li,LI Jian.Modified single-needle arthroscopic repair technique for the treatment of longitudinal meniscal tear[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(2):114~120
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