FasT-Fix修复半月板撕裂的愈合相关因素分析

Analysis on Correlated Factors of Meniscal Healing after Suture with FasT-Fix Repairing

目的:Fast-Fix半月板缝合系统是一种安全、有效的全关节腔内半月板缝合技术,目前对于半月板缝合术后的愈合影响因素仍不清楚。方法:2014年1月至2015年3月就诊于我科的半月板损伤患者,经关节镜探查证实为体后或后角的红区、红-白区损伤,在腰麻下行FasT-Fix半月板缝合术。患者于术后6个月进行门诊随访,由手术医生根据Barrett标准进行体格检查;同时行膝关节MRI检查,观察缝合部位MRI表现。分别记录不同性别、年龄(≤45岁,>45岁)、BMI(≤25,>25)、病程(≤6周,>6周)、是否有外伤史、撕裂类型(O'Connor分型)、术后制动时间(≤4周,>4周)等情况下半月板愈合的例数。结果:共纳入半月板损伤病例133例。共有110例患者临床症状消失且MRI所示损伤信号缩小或消失,认定为半月板愈合(82.7%)。统计比较显示,性别、年龄、撕裂分型、术后制动时间等对半月板愈合无影响;而BMI>25kg/m^2、病程>6周及无明确外伤史的患者,其半月板愈合率偏低。结论:对于BMI>25kg/m^2、病程>6周及无明确外伤史的患者,应谨慎把握缝合指征,仔细做好半月板创面新鲜化,缝合时注意解剖对位缝合以避免局部张力过大导致愈合延迟。

Objective：The FasT-Fix device is a safe and efficient choice for all-inside meniscal repair.However,the correlated factors for meniscal healing are still controversial.Methods：All the paitents with meniscal injury,admitted in our department from January 2014 to March 2015 as objects.The patients received arthroscopic meniscal repaire via FasT-Fix,under spinal anesthesia.The patients were followed up 6 months after the procedure.Physical examination and MRI were performed to detect the healing of the meniscus.The results were recorded according to different gender,age,BMI,disease course,history of trauma,injury classification and post-operative immobilization.Results：A total of 133 cases.With the follow-up,110 cases,had no clinical symptoms or no injury signal with MRI,were detected as meniscal healing（82.7%）.The statistical comparison showed that gender,age,0＇Conner classification,post-operative immobilization did not influence meniscal healing.While patients with BMI over 25kg/m2,disease course longer than 6 weeks and patients without definite trauma history had lower healing rate.Conclusions：Patient with BMI over 25kg/m^2,disease course longer than 6 weeks and unclear trauma history has negtive effects on menical healing after FasT-Fix repair.