Operative Orthopadie und Traumatologie · 2006
Arthroscopic meniscal repair with bioresorbable implants.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bohnsack Michael, Rühmann Oliver
Аннотация
OBJECTIVE: Restoration of the shape and function of a torn meniscus.
INDICATIONS: Complete or large incomplete longitudinal tear of the medial and lateral meniscus close to the base, large flap tear, so-called bucket-handle tear.
CONTRAINDICATIONS: Degenerative meniscal tissue. Unstable knee joint without concomitant surgical stabilization. Complex meniscal tear or radial tear. Tear in the central avascular region. Gonarthrosis. Joint infection. Local skin disorders.
SURGICAL TECHNIQUE: Visualization of the meniscal tear and revitalization of the tear margins with a meniscal rasp or shaver. Introduction of the implant using the surgical technique required and repair of the tear. Percutaneous trepanation of the meniscal base ("needling") to improve healing.
POSTOPERATIVE MANAGEMENT: Full weight bearing only with the knee joint extended in an orthosis until after the 6th postoperative week. Knee flexion up to 30 degrees without weight bearing for the first 2 postoperative weeks with physiotherapy, then up to 60 degrees for another 4 weeks. Short movable knee orthosis with 0-0-90 degrees in the 7th-12th postoperative week. After the 12th postoperative week, continuation of physiotherapy without orthosis, until range of movement has been achieved and the knee-stabilizing muscles have regained their strength. Full sporting capacity after 6 months.
RESULTS: The healing rate for meniscal repair with bioresorbable implants is between 86% and 95% and is comparable with the average healing rate for open (84-88%) or arthroscopic suture techniques (98%). Between July 1999 and June 2001, a meniscal tear was treated with Clearfix screws in 65 patients. 60 patients (92%) had a follow-up examination on average 18 months postoperatively. Six patients underwent further arthroscopic surgery as a result of pain (four times healed, twice not healed). Another three patients complained of pain on weight bearing at the follow-up examination and had clinically positive meniscus signs. These patients were then evaluated as "treatment failures". The clinical healing rate was therefore 92% (55 out of 60).
INDICATIONS: Complete or large incomplete longitudinal tear of the medial and lateral meniscus close to the base, large flap tear, so-called bucket-handle tear.
CONTRAINDICATIONS: Degenerative meniscal tissue. Unstable knee joint without concomitant surgical stabilization. Complex meniscal tear or radial tear. Tear in the central avascular region. Gonarthrosis. Joint infection. Local skin disorders.
SURGICAL TECHNIQUE: Visualization of the meniscal tear and revitalization of the tear margins with a meniscal rasp or shaver. Introduction of the implant using the surgical technique required and repair of the tear. Percutaneous trepanation of the meniscal base ("needling") to improve healing.
POSTOPERATIVE MANAGEMENT: Full weight bearing only with the knee joint extended in an orthosis until after the 6th postoperative week. Knee flexion up to 30 degrees without weight bearing for the first 2 postoperative weeks with physiotherapy, then up to 60 degrees for another 4 weeks. Short movable knee orthosis with 0-0-90 degrees in the 7th-12th postoperative week. After the 12th postoperative week, continuation of physiotherapy without orthosis, until range of movement has been achieved and the knee-stabilizing muscles have regained their strength. Full sporting capacity after 6 months.
RESULTS: The healing rate for meniscal repair with bioresorbable implants is between 86% and 95% and is comparable with the average healing rate for open (84-88%) or arthroscopic suture techniques (98%). Between July 1999 and June 2001, a meniscal tear was treated with Clearfix screws in 65 patients. 60 patients (92%) had a follow-up examination on average 18 months postoperatively. Six patients underwent further arthroscopic surgery as a result of pain (four times healed, twice not healed). Another three patients complained of pain on weight bearing at the follow-up examination and had clinically positive meniscus signs. These patients were then evaluated as "treatment failures". The clinical healing rate was therefore 92% (55 out of 60).