Pie-crusting技术在膝关节内侧间室松解中的应用

Application of Pie-crusting technique in arthroscopic repair of knee meniscus injury

先天发育因素及膝关节退变等原因常导致膝关节内侧间室狭窄。狭窄的内侧间室又增加了内侧半月板后角的损伤几率。当患者出现此处受损时选择关节镜手术切掉或缝合损伤的半月板后角是当下普遍认为疗效较好的治疗方式。但当进行内侧间室的手术操作时,常因为内侧间室狭窄导致视野受限及手术操作空间狭小,以至于在手术过程中难以对半月板进行手术操作甚至手术失败。国内外学者通过对膝关节解剖发现,可以对膝关节内侧的一系列韧带进行松解,扩大膝关节内侧间室,以达到关节镜下直视进行手术操作。这种松解操作既可以避免因视野丢失导致的误伤,又可以扩大间室方便手术器械的进入。这一类膝关节内侧韧带的松解技术被统称为Pie-crusting技术。借助该种技术可以便捷高效地进行膝关节内侧半月板的关节镜手术操作,节省手术时间,减少术中损伤的风险。因此许多国内外学者对这项技术感兴趣并深入研究。

Congenital developmental factors and knee joint degeneration often lead to the stenosis of the medial knee joint compartment.The narrowing of the medial compartment increases the probability of injury to the posterior angle of the medial meniscus.Arthroscopic surgery to cut or suture the posterior angle of the meniscus is generally considered to be the most effective treatment for patients with damage here.However,when the operation is performed in the medial compartment,the field of vision is often limited and the operation space is narrow due to the stenosis of the medial compartment,making it difficult to operate the meniscus during the operation or even the operation fails.Domestic and foreign scholars have found through the anatomy of the knee joint that a series of ligaments on the medial side of the knee joint can be released and the medial compartment of the knee joint can be expanded to achieve direct arthroscopic operation.This release procedure not only avoids accidental injury due to visual field loss,but also enlarges the compartment to facilitate access for surgical instruments.This kind of release technique of medial ligament of knee joint is collectively known as Pie-crusting technique.With this technique,arthroscopic operation of medial meniscus of knee joint can be performed conveniently and efficiently,saving operation time and reducing the risk of intraoperative injury.Therefore,many scholars at home and abroad are interested in this technique and study it deeply.