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A mid-term clinical follow-up study on repair of the meniscus tears by a modified arthroscopic outside-in puncture suture technique
Received date: 2020-01-08
Online published: 2020-10-15
Supported by
Ministry of Education Innovation Program of China(IRT_16R01);Key Laboratory of Trauma and Neural Regeneration (Peking University), Ministry of Education(BMU2019XY007-01)
Objective: To investigate the clinical effect of a modified arthroscopic outside-in suture technique in the treatment of meniscus tear using a spinal needle. Methods: From January 2015 to October 2017, 95 patients treated with this method were followed-up. Among these cases, there were 36 males and 59 females. The age of the patients ranged from 16 to 77 years,(46.79±18.07) years in average. Among them, there were 28 patieats aged 16-35, 53 patients aged 36-65, and 14 patients aged over 65 years old. 28 cases were diagnosed with medial meniscus tear, 43 cases with lateral meniscus tear and 24 cases with both medial and lateral meniscus tear. Causes of the injury included sports, sprain, etc. According to Barrett standard, the clinical healing of meniscus tear was judged. Lysholm score, knee range of motion,visual simulation score (VAS) and magnetic resonance imaging (MRI) were used to evaluate the postoperative knee function and recovery of the patients. Results: The 95 patients were followed up for 22 to 36 months, with an average of (28.32±3.98) months. According to Barrett standard, 90 patients (94.7%) obtained meniscus clinical healing. Meniscal healing rates were 96.43%, 96.23% and 85.71% in the three age groups, respectively. The meniscal healing rate was lower in the elderly group, but there was no significant difference in statistical results (P=0.262). Five patients had deep tenderness in the joint space of the injured side, and the overstretch test was positive. The preoperative and postoperative VAS scores, Lysholm scores and knee motion were compared in each group, and the differences were statistically significant (P<0.01). At the end of the last follow-up, there were no cases of knee joint effusion, swelling and interlocking, and the joint function was effectively improved in most patients. No surgical site infection, periarticular vascular/nerve injury or knotting reaction was found during the follow-up. Conclusion: This modified arthroscopic outside-in suture technique using a spinal needle has the characteristics of simple operation, small trauma and rapid recovery, and the mid-term follow-up results were satisfactory. Therefore, we consider this method to be a safe and efficient method for the treatment of meniscus anterior horn and body tear.
Key words: Meniscus; Arthroscopy; Knee joint
Zhong-di LIU , Ting-min XU , Yu DANG , Dian-ying ZHANG , Zhong-guo FU . A mid-term clinical follow-up study on repair of the meniscus tears by a modified arthroscopic outside-in puncture suture technique[J]. Journal of Peking University(Health Sciences), 2020 , 52(5) : 870 -874 . DOI: 10.19723/j.issn.1671-167X.2020.05.012
| [1] | Kurzweil PR, Cannon WD, DeHaven KE. Meniscus repair and replacement[J]. Sports Med Arthrosc Rev, 2018,26(4):160-164. |
| [2] | Vaquero-Picado A, Rodríguez-Merchín EC. Arthroscopic repair of the meniscus: surgical management and clinical outcomes[J]. EFORT Open Rev, 2018,3(11):584-594. |
| [3] | Karia M, Ghaly Y, Al-Hadithy N, et al. Current concepts in the techniques, indications and outcomes of meniscal repairs[J]. Eur J Orthop Surg Traumatol, 2019,29(3):509-520. |
| [4] | Steiner S, Feeley SM, Ruland JR, et al. Outside-in repair technique for a complete radial tear of the lateral meniscus[J]. Arthrosc Tech, 2018,7(3):e285-e288. |
| [5] | Barrett GR, Treacy SH, Ruff CG. Preliminary results of the T-fix endoscopic meniscus repair technique in an anterior cruciate ligament reconstruction population[J]. Arthroscopy, 1997,13(2):218-223. |
| [6] | Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale[J]. Am J Sports Med, 1982,10(3):150-154. |
| [7] | Fox AJ, Wanivenhaus F, Burge AJ, et al. The human meniscus: a review of anatomy, function, injury, and advances in treatment[J]. Clin Anat, 2015,28(2):269-287. |
| [8] | Ouyang X, Wei B, Hong SD, et al. Arthroscopic characteristics of normal and discoid meniscus injury, and efficiency of recovery in each type of meniscus injury[J]. Cell Biochem Biophys, 2015,72(2):433-437. |
| [9] | Badlani JT, Borrero C, Golla S, et al. The effects of meniscus injury on the development of knee osteoarthritis: data from the osteoarthritis initiative[J]. Am J Sports Med, 2013,41(6):1238-1244. |
| [10] | Rai MF, Brophy RH, Sandell LJ. Osteoarthritis following meniscus and ligament injury: insights from translational studies and animal models[J]. Curr Opin Rheumatol, 2019,31(1):70-79. |
| [11] | Rai MF, McNulty AL. Meniscus beyond mechanics: Using biology to advance our understanding of meniscus injury and treatment[J]. Connect Tissue Res, 2017,58(3/4):221-224. |
| [12] | Twomey-Kozak J, Jayasuriya CT. Meniscus repair and regeneration: a systematic review from a basic and translational science perspective[J]. Clin Sports Med, 2020,39(1):125-163. |
| [13] | Muniandy M, Rajagopal S, Tahir SH. Arthroscopic all-inside repair of tear of the anterior horn of discoid lateral meniscus[J]. Surg J (NY), 2019,5(1):e35-e37. |
| [14] | Muckenhirn KJ, Kruckeberg BM, Cinque ME, et al. Arthroscopic inside-out repair of a meniscus bucket-handle tear augmented with bone marrow aspirate concentrate[J]. Arthrosc Tech, 2017,6(4):e1221-e1227. |
| [15] | Marinescu R, Laptoiu D, Negrusoiu M. Outside-in meniscus suture technique: 5 years' follow-up[J]. Knee Surg Sports Traumatol Arthrosc, 2003,11(3):167-172. |
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