关节镜下Fast-Fix联合玻璃酸钠注射修复半月板损伤  

Fast-Fix combined with sodium hyaluronate in meniscal repair under arthroscope

作　　者：吴建伟[1] 樊国峰[1] 张天一[1] 乔金环[1] 路博[1] 孔繁林[1] 王增立[1] 

机构地区：[1]中国石油中心医院骨科,河北省廊坊市065000

出　　处：《中国组织工程研究》2015年第24期3788-3792,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:玻璃酸钠是一种高分子多糖类生物材料,许多研究认为其有一定的修复软骨表面、减少炎症递质释放、促进半月板修复的作用。目的:观察关节镜下Fast-Fix系统联合玻璃酸钠注射修复半月板损伤的疗效。方法:选取中国石油中心医院骨科2008年3月至2014年3月收治的半月板损伤患者86例,平均年龄25.5岁;病程平均1.5个月,表现为膝关节活动时疼痛、肿胀、旋转挤压试验阳性,MRI示半月板撕裂。均采用关节镜下Fast-Fix系统进行半月板缝合,在手术结束时沿套管通道注入玻璃酸钠注射液2.5 m L,术后隔1周关节腔内注射1次玻璃酸钠,共3次。采用膝关节Lysholm评分进行膝关节功能评价。结果与结论:81例获得随访,失访5例,平均随访1.5年。81例患者中79例关节交锁、显著压痛和活动障碍等症状消失,1年内复查MRI均见半月板愈合,Lysholm评分大于75分,优良率98%;2例在修复后1年仍存在肿胀和压痛,蹲起动作稍受限。提示关节镜下Fast-Fix联合玻璃酸钠注射修复半月板损效果良好,膝关节功能恢复满意。BACKGROUND：Sodium hyaluronate is a polysaccharide polymer biomaterial, which is considered to have a certain effect to repair the cartilage surface, reduce the release of inflammatory mediators, and promote meniscal repair. OBJECTIVE：To observe the therapeutic effect of Fast-Fix combined with sodium hyaluronate in meniscal repair under arthroscope. METHODS：Eighty-six patients with meniscus injury admitted at the Department of Orthopedics, CNPC Central Hospital, from March 2008 to March 2014 were enrol ed in the study. The average age was 25.5 years, and the average duration of disease was 1.5 months. The main clinical manifestations included knee joint pain and swel ing after exercise and positive McMurray signs. The MRI results showed meniscus tear or degeneration. Arthroscopic repairing surgeries were performed with Fast-Fix combined with sodium hyaluronate injection （2.5 mL at the end of surgery）, and then sodium hyaluronate was injected intraarticularly at 1, 2, 3 weeks after surgery. Each patient was assessed with Lysholm knee joint score system before and after operation. RESULTS AND CONCLUSION：Eighty-one patients were fol owed up for an average of 1.5 years and five patients were lost to fol ow-up. Joint locking, significant tenderness and movement disorder symptoms disappeared in 79 of 81 patients, and meniscal healing was shown on MRI review within 1 year after surgery;the Lysholm score was higher than 75 points, and the excel ent rate was 98%. Only the remained two patients felt swel ing and tenderness and the movement was slightly restricted when going down or standing up. The Fast-Fix combined with sodium hyaluronate in meniscal repair under arthroscope has good effect and good function of knee joint.

关 键 词：组织构建 软骨组织工程 玻璃酸钠 关节镜 半月板 

分 类 号：R318[医药卫生—生物医学工程]