ABSTRACT
Background: This article presents a mathematical justification for a new approach to arthroscopic stitching of the knee joint meniscus, based on a 3D computer model of the meniscus developed using the COMPASS-3D (APMFEM) program and AutodeskInventorPRO. The research with the patent RK No. 35413 dated 10.12.2021, titled "Method of arthroscopic stitching of the meniscus of the knee joint" builds upon the work of Yu.V. Labunsky. Methods: Mathematical analysis was performed to compare two methods of stitching the meniscus: the new oblique-vertical stitch and the classical vertical stitch. The contact area of the meniscus tissues in the area of the rupture was measured for both stitching methods. Results: The findings demonstrate that the new oblique-vertical stitch offers a 1.5 times larger contact area of the meniscus tissues in the area of the rupture, compared to the classical vertical stitch. Additionally, the new method provides a more significant grip on the radial and circular fibers of the meniscus, surpassing the capabilities of the classic seam. Conclusion: The results of this study can be utilized to develop practical recommendations for traumatologists regarding arthroscopic stitching of the meniscus in the knee joint. The new approach, supported by mathematical analysis and a 3D computer model, offers improved outcomes in terms of contact area and grip on the meniscus fibers, potentially leading to enhanced surgical techniques and patient outcomes.
ABSTRACT
Background: Meniscal injury is a common problem that can lead to knee pain and dysfunction. Meniscal repair and meniscectomy are two treatment approaches for meniscal injury, but the latter may increase the risk of osteoarthritis. We aimed to compare the 3-year outcomes of a new method of meniscal suturing with meniscectomy among patients with meniscal injury. Methods: This retrospective cohort study compared meniscal repair (treatment group) and meniscectomy (control group) in patients with meniscal injury. We evaluated the outcomes of 134 patients. under treatment with these approaches based on the Lysholm scale, which measures knee function and symptoms. The study used the chi-square test and the Mann-Whitney U test to compare the proportion of patients with different outcomes and the Lysholm scale scores between the treatment and control groups. The study also conducted subgroup analyses based on gender and age using the Mann-Whitney U test. The level of significance was set at P < 0.05 for all statistical tests. Results: The treatment group had a higher proportion of patients with excellent results, although the difference was not statistically significant (17.2% in the treatment group vs. 10.0% in the control group, P = 0.223). However, a comparative analysis of the proportion of patients with good results revealed statistically significant differences, with 67.2% of patients in the treatment group achieving good outcomes compared to 45.7% in the control group (χ2 = 6,256, df = 1 P = 0.012, HR 1,470 95%CI 1,081-1,999). The average score on the Lysholm scale was significantly higher in the treatment group (87.48, 95% CI 85.1-89.7, SD = 9.2) compared to the control group (81.73, 95% CI 78.4-84.9, SD = 13.7) (U = 1609, Z = -2.813, P = 0.005). Subgroup analyses based on gender and age also showed significant differences in the Lysholm scale scores. Conclusion: The study demonstrates that meniscal repair is more effective than meniscectomy in improving patient outcomes, with a higher proportion of patients achieving excellent and good results and higher scores on the Lysholm scale. These findings support the use of meniscal repair as a preferred treatment approach for patients with meniscal injuries.