The FasT-Fix Repair Technique for Ramp Lesion of the Medial Meniscus

INTRODUCTION: This technical note describes a new arthroscopic technique to repair the peripheral attachment lesion of the posterior horn of the medial meniscus. The operation was performed under arthroscopy using a standard anterior portal. SURGICAL TECHNIQUE: A FasT-Fix needle was inserted obliquely close to the tibial plateau and the first implant was inserted into the joint capsule depending on its bending angle underneath the meniscus. The second implant was inserted through 1/3 periphery of the meniscus into the meniscocapsular area. The pre-tied self-sliding knot was tensioned to achieve secure fixation of the posterior meniscal peripheral attachment at the original attachment point. MATERIALS AND METHODS: From August 2011 to February 2014, 23 knees were diagnosed as ramp lesion, underwent meniscal repair using FasT-Fix technique. RESULTS: All patients were followed up for average 14 months. The Lysholm score improved from preoperative 64.4+/-4.52 to postoperative 91.2+/-4.60. CONCLUSIONS: We believe that the FasT-Fix technique via the standard anterior portal can be a more convenient and less traumatic alternative for repair of the peripheral attachment lesion of the posterior horn of the medial meniscus in the anterior cruciate ligament deficient knee.

FasT-Fix technique for suturing degree Ⅲ horizontal meniscus tears / 中华创伤杂志

Objective To investigate the results of FasT-Fix technique in repair of degree Ⅲ horizontal meniscus tears.Methods From June 2010 through June 2013,12 patients with degree Ⅲ horizontal meniscus tears underwent arthroscopic vertical mattress suture using the FasT-Fix technique.There were 7 males and 5 females at mean age of 34.7 years.All the patients were diagnosed with combined anterior cruciate ligament (ACL) rupture with preoperative Lysholm score of (64.9 ± 9.4)points.Arthroscopic meniscus repair was performed prior to ACL reconstruction.A second-look arthroscopy examined the healing status of the meniscus at 6 to 18 months postoperatively (mean,12 months).Lysholm score was evaluated during outpatient follow-up.Results All the patients were available to the follow-up of 26 months (range,12-36 months).Second-look arthroscopy showed complete healing in 9 patients and incomplete healing in 3 patients.At final follow-up,Lysholm score was (93.4 ± 5.0) points.Conclusion FasT-Fix technique can repair degree Ⅲ horizontal meniscus tears with vertical mattress sutures and reconstruct ACL,which has advantages of allowing maximal preservation of the horizontally torn meniscus,minor trauma,easy operation and definite efficacy.

Treatment of posterior and anterior ankle impingement syndrome with combined anterior, tarsal sinus and posterolateral approaches under arthroscopy / 中华创伤杂志

Objective To discuss the methods and effects of arthroscopic treatment of posterior and anterior ankle impingement syndrome through anterior approach,tarsal sinus approach plus posterolateral approach.Methods The study enrolled 12 patients with posterior and anterior ankle impingement syndrome treated from January 2012 to March 2014.There were 8 males and 4 females,agedl7-65 years (mean,45 years).Left ankle injury was noted in 9 patients and right ankle injury in 3 patients.Eight patients had a history of obvious ankle injury (5 acute and 3 chronic sprains).Arthroscopic surgery was performed to manage the posterior and anterior ankle impingement syndrome through the combined anterior,tarsal sinus and posterolateral approaches,and prone position and posteromedial incision were not used during operation.Postoperative outcome was evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score.Results Operation time was 45-80 min (mean,62 min).Arthroscopy confirmed anterior bone impingement in all patients.Three patients suffered from posterior bony impingement of the talus,while nine patients os trigonum injury.Duration of follow-up was 10-18 months (mean,14 months).AOFAS score was (91.4-± 6.5) points after operation,significantly higher (34.4 ± 12.6) points before operation (t =14.607,P ＜0.01).All patients had normal ankle range of motion after operation.There were no complications such as neurovascular injury.All the surgical incisions achieved primary healing.Conclusion The procedure avoids body position shift and posteromedial incision during operation,and attains a good vision to the anterior and posterior portions and satisfactory short-term outcome.

The mid-term results of arthroscopic anterior cruciate ligament reconstruction using Transfix technique / 中华骨科杂志

Objective To evaluate the mid-term results of arthroscopic anterior cruciate ligament (ACL) reconstruction using Transfix technique.Methods From August 2002 to December 2003,38 patients (24 left knees and 14 right knees) with ACL ruptures underwent arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation.There were 21 males and 17 females,aged from 19 to 48 years (average,28.4 years).The causes of injury included sports injury in 27 cases,traffic injury in 2 cases and fall injury in 2 cases,and 7 patients had no significant injury.There were 6 cases of acute injury and 32 cases of old injury.Anterior drawer test was positive in 35 cases,weak positive in 1 case and negative in 2 cases.Lachman test was positive in 37 cases,and weak positive in 1 case.The Lysholm score was used to evaluate the results.Moreover,X-rays and MRIs were used to observe the conditions of graft and bone tunnel.Results Thirty-six patients were followed up for 6.3 to 7.6 years (average,6.8 years).All patients had normal joint range of motion.The Lysholm score improved from preoperative 64.4±4.52 to postoperative 85.6±4.60,and the difference was statistically significant (P ＜ 0.05).The X-rays and MRIs showed femoral and tibial tunnel enlargement in 3 cases,femoral tunnel enlargement in 5 cases and tibial tunnel enlargement in 3 cases.No joint space narrowing was found in all patients.One patient underwent arthroscopic revision ACL reconstruction with allograft tendon using bioabsorbable interference screws fixation on both tibial and femoral sides for re-rupture of ACL 4 years after operation due to trauma.Conclusion Arthroscopic ACL reconstruction with hamstring tendon using Transfix femoral fixation and interference screws tibial fixation is an effective method,which can provide satisfactory joint range of motion and stability.

OBSERVATIONS ON CFU-C OF THE BONE MARROW OF THE PATIENTS WITH APLASTIC ANEMIA AND ITS INFLUENTIAL FACTORS / 解放军医学杂志

Bone marrow from 20 patients suffering from aplastic anemia were cultured with fetal muscle condition medium and in three different combinations: (1) Marrow from the patients cultured alone; (2) Coculture of marrow from patient with normal marrow; and (3) Culture of normal marrow with serum from patient. It was found that: (1) Nine patients had low colony formation when culture alone; no suppression in coculture and no inhibiter factor was found in serum from patient. Stem cells might be absent or defective in these patients. (2) Five patients had low colony when cultured alone; their marrow showed marked inhibitory effect on normal marrow CFU-C in coculture. and the latter was decreased by 40-100%. Suppressor cells might have caused the aplasia in these patients. (3) The sera from five patients suppressed CFU-C of normal marrow cells, colony counts being decreased by 55-77%. The cause of aplasia in these patients might be the presence of an humoral inhibiting factor. (4) In one patient no abnormal findings were found in all three different combinations of cultures. This patient might be suffering from a defective hematopoietic environment.