关节镜下AR缝合枪缝合外侧半月板撕裂的临床疗效观察

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Abstract Objective To investigate and analyze the short and medium term clinical effects of total internal vertical mattress suture with AR (Arthrex) suture gun under arthroscopy for lateral meniscus spallation or longitudinal tear.Methods The clinical data of 36 patients，including 13 males and 23 females，aged 16 to 41 with an average of (26.5±2.5)years，with simple lateral meniscus tear (spallation or longitudinal tear) in our department from January to December 2017 were retrospectively analyzed，including 7 discoid meniscus injuries.The outer meniscus was repaired and cut into the margin of the white area during the operation to preserve the junction of the red and white area，and the body layer or longitudinal tear.After freshness treatment，AR suture gun was used to suture the meniscus by vertical mattress suture method.The clinical healing of meniscus body suture was judged according to Barrett standard outpatient follow-up after operation.Visual analogue pain score (VAS score)，subjective knee function score (IKDC 2000 score) and knee function at different time were compared by repeated measurement variance analysis.The difference of Lysholm score was used to evaluate the effect of surgical suture.The knee joint was examined by MRI 12 months after operation to observe the recovery of suture site.Results All 36 patients were followed up for 12 to 18 months (15.00±2.30).There were no complications such as infection，neurovascular injury and secondary operation.According to Barrett criteria，meniscus healing was achieved in all patients.VAS scores of 3 months，6 months and 12 months after operation were (1.10±0.12)，(1.00±0.21)，(0.90±0.32).The IKDC 2000 scores of 3 months，6 months and 12 months after operation were (82.34±3.15)，(85.34±5.17)，(87.34±4.18) significantly higher than those before operation (40.51±5.54)，with statistical significance (P＜0.05)；the Lysholm scores of 3 months，6 months and 12 months after operation were (87.38±6.18)，(88.52±4.19)，(90.34±4.22) significantly higher than those before operation (42.11±6.82)，the difference was statistically significant (P＜0.05).The 12-month follow-up of MRI showed that 34 cases (94.44%) healed in grade A，1 case (2.78%) healed in grade B and 1 case (2.78%) did not heal.Conclusion Arthroscopic total internal vertical mattress suture with AR suture gun for lateral meniscus tear (spallation or longitudinal fissure) can effectively relieve pain，improve limb function and promote meniscus healing，and it has the advantages of simple operation and fewer complications.Its clinical efficacy is remarkable in short and medium term follow-up.Further follow-up and follow-up are needed for the long-term efficacy.

Key words： lateral meniscus AR suture gun vertical mattress suture arthroscopy knee joint

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