早读 | 【手术技术】外侧半月板腘肌裂孔腱区损伤全内缝合技巧

时间:2023-06-30 11:08:12 来源: 个人图书馆-骨科笔记


(相关资料图)

最后,为什么arth君今天给大家带来这样一个缝合小技巧,主要是因为我们一直不推荐腘肌腱与半月板缝合,虽然有相关报道称将半月板与腘肌腱缝合,长期随访疗效切确且无严重并发症,但许多学者指出,腘肌腱在腘肌腱裂孔处产生动力滑动,如果与不同运动轨迹的外侧半月板缝合,势必会存在缝合切割的风险,这不仅影响外侧半月板的愈合,也影响腘肌腱的功能。所以无论术中采取由外向内、由内向外和全内缝合技术都可使半月板和关节囊闭合, 但这些缝合技术可能存在缝合腘肌腱或缩小腘肌腱裂孔的风险。

参考文献

1. Cohn AK, Mains DB. Popliteal hiatus of the lateral meniscus. Anatomy and measurement at dissection of 10 specimens. Am J Sports Med. 1979;7(4):221–226.

2. Stäubli HU, Birrer S. The popliteus tendon and its fascicles at the popliteal hiatus: Gross anatomy and functional arthroscopic evaluation with and without anterior cruciate ligament deficiency. Arthroscopy. 1990;6(3):209–220.

3. LaPrade RF, Wozniczka JK, Stellmaker MP, et al. Analysis of the static function of the popliteus tendon and evaluation of an anatomicreconstruction: the "fifth ligament" of the knee. Am J Sports Med. 2010;38(3):543–549.

4. Guimaraes JB, Facchetti L, Schwaiger BJ, et al. Natural evolution of popliteomeniscal fascicle tears over 2 years and its association with lateral articular knee cartilage degeneration in patients with traumatic anterior cruciate ligament tear. Eur Radiol. 2018;28(8):3542–3549.

5.Zheng JP, Xiao Q, Deng HY, Wu QQ, Zhai WL, Lin DS. [Arthroscopic classification and management for the popliteal hiatus of the lateral meniscus tears]. Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Oct 18;53(5):891-895.

6.Wang Y, Chen J, Li D, Yang R, Xiang X. Single Needle All-Inside Technique for Lateral Meniscus Repair at Popliteal Hiatus Area: Safe, Effective, and Time-Saving. Arthrosc Tech. 2023 Feb 20;12(3):e371-e375.

标签:

X 关闭

X 关闭