FasT-Fix半月板缝合的临床疗效与MRI造影评估愈合研究

Clinical Results and MRI Arthrography Evaluation of Meniscal Repair with FasT-Fix System

目的:了解关节镜下使用FasT-Fix系统进行半月板缝合的临床疗效与MRI造影下的愈合情况。方法:2006年4月至2007年7月,17例患者、18侧损伤半月板在我所应用Fast-Fix系统进行了关节镜下全内的半月板缝合,所有患者同时进行了交叉韧带重建,于术后平均11个月进行临床随访,依照Barrett标准评价半月板缝合的临床愈合情况,并对随访患者进行IKDC、Lysholm和Tegner评分。所有18侧半月板应用MRI造影评价半月板愈合情况。结果:18侧缝合的半月板有17侧得到了临床愈合,临床愈合率为94.4%。平均IKDC评分由术前的46.4分提高至术后的75.2分,平均Lysholm评分由术前的44.8分提高至术后的80.6分,平均Tegner评分由术前的2.5分提高至术后的5.4分。MRI造影显示18侧半月板中13侧为完全愈合,2侧为部分层厚不愈合,3侧为全层厚不愈合,总愈合率为83.3%,完全愈合率为72.2%。结论:应用Fast-Fix系统进行半月板缝合具有很好的临床效果,MRI造影显示有较高的愈合率。

Objective To evaluate the clinical results and healing condition via MRI arthrography after arthroscopic meniscal repair with FasT-Fix system. Methods 18 all-inside arthroscopic meniscal repair with FasT-Fix system were performed in our institute with 17 patients from April 2006 to July 2007. Concurrent anterior cruciate ligaments reconstruction were performed in all patients. The average period of follow up was 11 months. Clinical healing process was evaluated according to Barrett criteria. IKDC score,Lysholm score and Tegner score were compared before and after operation. The healing condition of 18 menisci were evaluated by MRI arthrography. Results 17 of 18 repaired menisci were considered clinical healing and the healing rate was 94.4%. The mean IKDC score improved from 46.4 preoperatively to 75.2 postoperatively. The mean Lysholm score improved from 44.8 preoperatively to 80.6 postoperatively. The mean Tegner score improved from 2.5 preoperatively to 5.4 postoperatively. Confirmed with MRI arthrography,13 of 18 menisci were healing completely,2 menisci were partial-thickness healing and 3 menisci were full-thickness unhealing. The total healing rate was 83.3% and complete healing rate was 72.2%. Conclusion Arthroscopic meniscal repair using FasT-Fix system could provide good clinical results.