半板修复技术运动医学研讨会.pptx

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MENISCUSREPAIRTECHNIQUESSymposiumSportsMedicine-MeniscusProf.PedroGuillén;MD,PhDOrthopedicSurgeryDepartment,ResearchUnit,ClínicaCEMTRO,Madrid,Spain

Meniscalrepairtechniques

3Fairbank(J.BoneandJointSurg(Br)1948:30B:664Importanceofmeniscalrepair

Meniscotheque1978–1998223diferentmeniscaltears Unique meniscothequein theworld 4

1883ThomasAnnandaleFirstopenmeniscalrepair1969HiroshiIkeuchiFirstarthroscopicmeniscalrepair. 1980HenningFirstarthroscopicmeniscalrepairinUSA

Vascularization

Vascularization

Vascularization

9Generalindicationsformeniscalrepair

10“Goldstandard”Inside-outmeniscalrepairmeniscalHennigtechniqueFoto

Arthroscopy:TheJournalofArthroscopicandRelatedSurgery,Vol20,No8(October),2004

Loadtofailure?Inside-outFiberwire?MeniscalCinch?UltraFastFix120N64.8N88NInside-outmeniscalrepair Destacadodestacadodestacadodestacadodestacado.Destacadodestacado.Rossoetal.Comparisonofall-insidemeniscalrepairdeviceswithmatchedinside-outsuturerepair.AJSM2011;39:2634-9 12

13SimpleCheapStableAnteriorandmiddlethirdsOutside-inmeniscalrepair

14HorizontalOutside-inmeniscalrepairSutureconfigurationsVertical

15MonofilamentsuturesMinorcomplications

16TextoAll-insidemeniscalrepairFirstgeneration90

17MitekFastener,ClearFixyBiostinger75%implant–relatedchondraldamageatsixmonthsAllinsidemeniscalrepairFirstgeneration90MillerMD,KlineAJ,JepsenKJ.“All-inside”meniscalrepairdevices:anexperimentalstudyinthegoatmodel.AmJSportsMed.2004

TypeofStudy:Nonrandomizedprospectivecohortstudy.Methods:BioStingers(group1),verticalinside-outsutures(group2),orhybridrepairs(group3).Results:85,89repairs,FU26.5months.47BioStinger(group1),29suture(group2),and13hybrid(group3).Therewere73repairsassociatedwithACLreconstructions.TwoBioStingerrepaircaseshadjoint-linetendernessfromdevicemigrationconfirmedby

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