Author/Editor		Senekovič, Vladimir; Štrus, Katja; Krkovič, Matija
Title		Artroskopska rekonstrukcija meniskusa z bioresorbilnimi puščicami v lokalni anesteziji
Translated title		Arthroscopic meniscus repair with bioabsorbable arrows in local anesthesia
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 11
Publication year		2004
Volume		str. 825-8
Language		slo
Abstract		Background. The menisci have important function in the knee joint. Because of this it is universally accepted that we have to preserve them as much as possible. After open and partially arthroscopic suture techniques new methods of all-inside meniscus repair with bioabsorbable arrows have been developed in the last decade. The meniscus repair using these arrows represents an easy task for a skilled surgeon. In addition, it can be performed in local anesthesia. We have evaluated the results of the first group of patients who were treated by this method. Methods. From February 2001 to August 2002 15 patients with torn meniscuses have been treated at the Clinical Department for Traumatology, University Medical centre, Ljubljana. We repaired their torn menisci arthroscopically with bioabsorbable arrows in local anesthesia. We divided patients in three groups: a group with isolated meniscus injury, a group with meniscus injury and anterior cruciate ligament injury and a group with associated pathology. Four patients had incarcerated meniscuses. Preoperative Lysholm score in the first group was 38, in the second 42 and in the third group 48. We repaired 12 medial and 3 lateral meniscuses. On average we need 45 minutes for therapeutic arthroscopy. Torn meniscus was fixated with minimum of 1 and maximum of 5 bioabsorbable arrows. All patients except one had the affected knee immobilized with cylinder plaster for 15 days on average. Results. At least three months after the arthroscopic fixation of the torn meniscus in local anesthesia another clinical evaluation was made. In all groups significant improvement was observed regarding the range of motions and absence of pain. Postoperative Lysholm score in the first group was 89, in the second 75 and in the third 71. Average deficit offlexion was 3 degrees while extension was full. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Zaradi pomembne vloge meniskusov v kolenskem sklepu je splošno sprejeto, da jih je potrebno ob poškodbi čimbolj ohraniti. Preko odprtega in kasneje deloma artroskopskega šivanja meniskusov so v zadnjem desetletju razvili tudi metode povsem znotraj sklepne učvrstitve strganega meniskusa z bioresorbilnimi puščicami. Rekonstrukcija meniskusa s temi puščicami je za primerno usposobljenega kirurga enostavna in jo lahko izvedemo tudi v lokalni anesteziji. Retrospektivno smo ocenili rezultate prve serije bolnikov, ki smo jih zdravili na ta način. Metode. Na Kliničnem oddelku za travmatologijo v Kliničnem centru Ljubljana smo od februarja 2001 do avgusta 2002 zaporednim 15 bolnikom z longitudinalno strganim meniskusom artroskopsko učvrstili meniskus z bioresorbilnimi puščicami v lokalni anesteziji. Bolnike smo razdelili v tri skupine: skupino samo s poškodbo meniskusa, skupino s poškodbo meniskusa in sprednje križne vezi in skupino s strganim meniskusom in drugo pridruženo patologijo. Štirje so imeli ukleščen meniskus. Predoperativna ocena po Lysholmu v prvi skupini je bila 38, v drugi 42 in v tretji 48. Zašili smo 12 medialnih meniskusov in 3 lateralne. Za operacijo smo v povprečju porabili 45 minut, strgan meniskus smo učvrstili z najmanj eno in največ 5 puščicami. Vsem bolnikom, razen enemu, smo koleno imobilizirali z mavčno longeto, ki so jo nosili v povprečju 15 dni. Rezultati. Bolnike smo klinično ocenili po Lysholmu po preteku vsaj treh mesecev po opravljeni artroskopski učvrstitvi meniskusa v lokalni anesteziji. V vseh treh skupinah je prišlo do bistvenega izboljšanja tako v smislu gibljivosti kot odsotnosti bolečin. Pooperativna ocena po Lysholmu v prvi skupini je bila 89, v drugi 75 in v tretji 71. Povprečni deficit fleksije je bil 3 stopinje, ekstenzija je bila popolna. En bolnik je tožil za nadaljnjimi neprestanimi bolečinami. (Izvleček skrajšan pri 2000 znakih).
Descriptors		KNEE INJURIES MENISCI, TIBIAL ARTHROSCOPY ANESTHESIA, LOCAL SUTURES TREATMENT OUTCOME