摘要
目的 对比关节镜下经胫骨隧道拉出缝合与Fast-Fix全内半月板缝合器修复内侧半月板后根LaPrade Ⅱ型损伤的手术安全性、临床功能及影像学愈合情况，总结技术要点与临床体会。方法 回顾性纳入2020年1月-2024年6月收治的内侧半月板后根LaPrade Ⅱ型损伤患者30例（30膝），分为经胫骨隧道组（18例）与Fast-Fix全内缝合器组（12例）。术前及术后3、6、12、24个月采用VAS、Lysholm、IKDC、KOOS评分评估功能；术后24个月MRI评估愈合与半月板突出度，X线评估K-L分级。结果 随访24-36个月，两组术后各时间点VAS降低、功能评分升高（P<0.05），组间无差异。MRI总愈合率93.3%，半月板突出度显著改善，K-L分级无明显进展。结论 经胫骨隧道与Fast-Fix全内缝合器修复LaPrade Ⅱ型损伤均安全有效；精准复位、足印区新鲜化与规范康复是提升疗效的关键。
关键词： 内侧半月板后根；LaPrade Ⅱ型损伤；关节镜；经胫骨隧道；Fast-Fix全内半月板缝合器；疗效观察
Abstract
Objective To compare the surgical safety, clinical function and imaging healing status between arthroscopic trans-tibial tunnel pull-out suture and Fast-Fix all-inside meniscal repair device in the treatment of LaPrade Type Ⅱ posterior medial meniscus root injury, and summarize the technical key points and clinical experience. Methods A retrospective study was conducted on 30 patients (30 knees) with LaPrade Type Ⅱ posterior medial meniscus root injury admitted from January 2020 to June 2024, who were divided into trans-tibial tunnel group (18 cases) and Fast-Fix all-inside repair device group (12 cases). Clinical function was evaluated by VAS, Lysholm, IKDC and KOOS scores preoperatively and at 3, 6, 12 and 24 months postoperatively. Healing status and meniscal extrusion were assessed by MRI at 24 months postoperatively, and K-L grading was evaluated by X-ray. Results All patients were followed up for 24 to 36 months. VAS scores decreased and functional scores increased at each time point postoperatively in both groups (P<0.05), with no significant difference between groups. The overall MRI healing rate was 93.3%, meniscal extrusion was significantly improved, and K-L grading showed no obvious progression. Conclusion Both trans-tibial tunnel suture and Fast-Fix all-inside repair device are safe and effective for LaPrade Type Ⅱ injury. Precise reduction, footprint preparation and standardized rehabilitation are the keys to improving clinical outcomes.
Key words： Posterior medial meniscus root; LaPrade Type Ⅱ injury; Arthroscopy; Trans-tibial tunnel; Fast-Fix all-inside meniscal repair device; Clinical outcome observation
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