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Objective:To compare the outcomes of arthroscopic all-inside repair using puncture needle combined with suture hook versus meniscus repair device Fast-Fix for the treatment of meniscal tear in popliteal hiatus region.Methods:A retrospective cohort study was performed on the clinical data of 48 patients with meniscal tear in popliteal hiatus region admitted to Second People′s Hospital of Fujian Province from January 2014 to December 2017. There were 32 males and 16 females, aged 16-44 years [(28.0±7.8)years]. A total of 25 patients were treated with arthroscopic all-inside repair using puncture needle combined with suture hook (needle-hook group) and 23 patients were treated with meniscus repair device Fast-Fix (Fast-Fix group). The operation time and intraoperative blood loss were compared between the two groups. The function of knee joint was evaluated by Lysholm score, Tegner score and International Knee Documentation Committee (IKDC) score before operation, at 6 months after operation and at the last follow-up. The meniscal healing rate was evaluated by MRI scan at the last follow-up. During the period of follow-up, the incidence of complications (infection, popliteal tendon injury, foreign body irritation, etc.) was compared between the two groups.Results:All patients were followed up for 24-36 months [(25.8±2.5)months]. No significant differences were observed in operation time and intraoperative blood loss between the two groups (all P>0.05). The preoperative Lysholm score, Tegner score and IKDC score were not significantly different between the two groups (all P>0.05). The Lysholm score, Tegner score and IKDC score in needle-hook group were (96.7±3.8)points, (4.3±1.6)points and (95.5±5.4)points at 6 months after operation, significantly higher than those in Fast-Fix group [(93.3±1.6)points, (3.6±0.8)points, (91.9±0.8)points] (all P<0.05). The Lysholm score, Tegner score and IKDC score in needle-hook group were (99.6±1.3)points, (6.1±0.8)points and (99.4±0.2)points at the last follow-up, significantly higher than those in Fast-Fix group [(94.5±1.6)points, (4.8±0.2)points and (97.4±0.5)points] (all P<0.01). The above three scoring systems scored significantly higher in the two groups at 6 months after operation and at the last follow-up than those before operation (all P<0.01). MRI scan showed that the meniscus healing rate in needle-hook group was 92% (23/25) at the last follow-up, higher than 70% (16/23) in Fast-Fix group ( P<0.05). During the period of follow-up, no complication was observed in needle-hook group, but 6 patients [26% (6/23)] in Fast-Fix group had discomfort in the posterolateral muscle of the knee, which was related to popliteal tendon injury or foreign body irritation ( P<0.01). Conclusion:For meniscal tear in popliteal hiatus region, arthroscopic all-inside repair using puncture needle combined with suture hook is superior to meniscus repair device Fast-Fix in aspects of better knee function, higher meniscus healing rate and lower complication rate.
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Objective To observe the early clinical outcomes of iliotibial band with Gerdy's tubercle transplantation for irreparable rotator cuff tears (IRCT).Methods A total of 16 patients with IRCT who underwent iliotibial band with Gerdy's tubercle transplantation from June 2014 to June 2015 and with a minimum follow-up of 2 years were retrospectively analyzed.There were 4 male and 12 female with a mean age of 56.1±6.6 years old (range 44-67 years old).The X-ray and MRI were used to evaluate the improvement of acromiohumeral interval (AHI),rotator cuff healing and final outcome of bone graft postoperatively.Functional outcomes were assessed by visual analogue scale (VAS),American Shoulder and Elbow Surgeon (ASES) and Constant-Murley score.Results The average follow-up duration was 25.3±1.5 months (range 24-48 months).At the final follow-up,the forward flexion,external rotation and internal rotation were 159.37°±8.51°,35.31°±8.26° and 11.00°±2.52°,respectively.There was statistically significant difference between preoperative and postoperative joint range of motion (P ＜ 0.05).At the 3 months postoperatively,all patients had complete bone union between the Gerdy's tubercle and the greater tubercle.However,at the final followup,partial or complete bone absorption was observed in 6 patients.Twelve patients had complete rotator cuff healing,and 4 patients had partial healing.No patient had rotator cuff retear.The AHI increased significantly from 3.63±1.25 mm preoperatively to 8.37± 1.02 mm postoperatively (P ＜ 0.05).The postoperative VAS,ASES and Constant-Murley score were 1.06±0.93,81.75±6.80 and 77.12± 6.72,respectively.The differences between preoperative and postoperative VAS,ASES and Constant-Murley score were statistically significant (P ＜ 0.05).There was significant difference in postoperative VAS between bone absorption group and non-absorption group (P ＜ 0.05),while no significant difference was found in ASES or Constant-Murley score (P ＞ 0.05).Conclusion All patients had complete or partial rotator cuff healing.However,37.5％ of the patients had bone absorption and obtained a worse VAS score.The iliotibial band with Gerdy's tubercle transplantation for IRCT could significantly restore the joint function at 2 years postoperatively.
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Objective To determine the medium-long term functional outcome of arthroscopic repair of type II SLAP lesions with two loops.Methods According to retrospective study,29 cases patients with arthroscopic repairs of isolated type II SLAP lesions were collected from March 2011 to June 2013,the mean patient age at the time of surgery was 31.8 years(range17 to 47 years).All patients with ground anchor suture,and through double loop knot technology to fix SLAP injury.Visual analogue scale(VAS),Kerlan-Jobe Orthopaedic Clinic(KJOC),Roche Shouder function Score(ROWE) were used to determine the function of shoulder joint.The shoulderjoint range of motion before treatment and post treatment were recorded,shoulder joint mobility was recorded,satisfaction survey was done,compared the preoperative and postoperative data to evaluate its clinical effect.Results All patients were available for follow-up of 2.7-5.2 years.Overall,functional outcome was improved from baseline compared with final follow-up for VAS scores((4.3±1.2) points vs.(1.5±0.8) points,t=5.435,P<0.05),KJOC scores((72.1±4.9) points vs.(92.8±5.4) points,t=5.921,P<0.01),and ROWE scores((54.1±12.4) points vs.(84.3±10.2) points,t=7.326,P<0.01).Only a minority of patients feel pain when they did srenuous exercise.According to satisfaction investigation of patients,patient satisfaction was reported in 89.7%,3 cases had not good results,they could not return to previous level of play,including 2 cases were athletes,1 case was not athlete.Conclusion There is no more persistent pain and dysfunction after surgery,a good or excellent medium-long term functional outcome can be anticipated after arthroscopic repair of type II SLAP lesions with two loops.
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Objective To determine the clinical characteristics and its effect on the clinical efficacy of residual bony impingement lesion after hip arthroscopic osteoplasty for pincer-type femoroacetabular impingement.Methods There were 30 patients who underwent hip arthroscopic osteoplasty for isolated pincer-type femoroacetabular impingement from December 2010 to January 2012 and had a minimum follow-up period of 2 years,including 21 males and 9 females.The average age at surgery was 34.5 years (range from 28-42 years).All of the patients had no advanced hip arthritis and the T(o)nnis grade was 0-2.Radiological evaluation was performed by 3-dimensional CT.According to residual rate,these patients were divided into 3 groups:residual rate ＜10％ group,residual rate of 10％-20％ groups and residual rate ＞20％ group.Results The average follow-up period was 26.3 months (range,22-34 months) and nineteen cases had residual bony impingement lesion after surgery.Among them,84.2％ of the residual bony impingement lesion was posterior to the acetabular actual resection zone.The preoperative and postoperative bony impingement angle were 77.47°±21.31° and 12.94°±18.04°,respectively.The residual rate was 16.7％± 8.83％.The modified Harris hip score got significantly improved from 55.18±7.96 preoperatively to 94.71±4.39 postoperatively.The overall satisfactory rate was 76.7％,and the postoperative modified Harris hip score for these three groups was 95.86±1.71,95.23±1.99 and 85.52±6.41,respectively.The postoperative modified Harris hip score in residual rate ＞20％ group was significantly worse than those in other two groups.The satisfactory rate was 92.9％,80.0％ and 33.3％,respectively.The satisfactory rate in residual rate ＞20％ group was significantly worse than those in other two groups.There was a significant negative linear relationship between the residual rate and postoperative modified Harris hip score (R2=0.516,P=0.001).Conclusion The incidence of residual bony impingement lesion after hip arthroscopic osteoplasty for pincer-type femoroacetabular impingement was 63.3％.The residual rate was 16.7％.The residual impingement lesion was mainly at the posterior part of the acetabulum.The patients with residual rate ＞20％ got significantly worse clinical score and satisfactory rate.