Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES IN ADOLESCENTS: OUTSIDE-IN SUTURING VERSUS MENISCAL DART TECHNIQUE/ARTROSKOPSKO LIJECENJE OZLJEDA MENISKA U ADOLESCENATA: USPOREDBA TEHNIKE SIVANJA IZVANA-UNUTRA I MENISKEALNIH STRELICA
The aim of this study was to evaluate clinical and subjective outcomes of the meniscal dart technique in patients having undergone arthroscopic meniscal repair by comparing it with the outside-in suturing technique. From January 2006 until June 2017, case records of 37 patients having undergone arthroscopic meniscal repair were retrospectively reviewed. The patients were divided into two groups based on the technique used for meniscal repair, as follows: 18 patients in suture technique group and 19 patients in meniscal dart group. Each patient was analyzed for the following parameters: age, gender, mechanism of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and results of follow-up (Lysholm and International Knee Documentation Committee (IKDC) score). There were no statistically significant differences between the groups according to clinical outcomes except for anatomic injury localization (p=0.035). Median of operation time was 62.5 min in suture technique group and 70 min in meniscal dart group (p=0.184); median of hospital stay was 2 days for both groups (p=0.951); median of Lysholm score was 86.5 and 84.5 (p=0.651); and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support arthroscopic repair of meniscal tears, since both the suture technique and the meniscal dart technique are safe and successful in meniscal repair in children, with good long-term results and without important complications. Keywords: Meniscus; Meniscal repair; Children; Meniscal dart; Suture; Arthroscopy Cilj ovoga istrazivanja je bio analizirati klinicke i subjektivne ishode lijecenja u bolesnika operiranih zbog ozljeda meniska te usporediti dvije skupine bolesnika operiranih razlicitim tehnikama popravka meniska. Od sijecnja 2006. do lipnja 2017. godine u studiju je ukljuceno 37 bolesnika koji su lijeceni artroskopski zbog rupture meniska. Bolesnici su podijeljeni u dvije skupine ovisno o vrsti kirurskog zahvata: jednu skupinu skupinu cinilo je 18 bolesnika u kojih je meniskus sivan tehnikom postavljanja savova, a drugu 19 bolesnika u kojih su upotrebljene strelice za fiksaciju meniska. Svakom ispitaniku analizirani su sljedeci parametri: dob, spol, mehanizam nastanka ozljede, lateralizacija ozljede i meniska, anatomska lokalizacija ozljede i pridruzene ozljede. Ispitanicima koji su podvrgnuti tehnikama popravka meniska analizirani su jos i vrsta kirurske tehnike popravka meniska, rezultati subjektivne evaluacije 4 tjedna nakon operacije putem upitnika Lysholm i IKDC (Internationa! Knee Documentation Committee) te komplikacije nakon operacije. Izmedu skupina bolesnika operiranih tehnikom postavljanja savova i tehnikom fiksacije meniska strelicama nije bilo znacajne razlike u promatranim ishodima lijecenja, osim za anatomsku lokalizaciju ozljede (p=0,035). Medijani operacijskog vremena u skupini bolesnika operiranih tehnikom postavljanja savova iznosio je 62,5 min, dok je u skupini fiksacije meniska strelicama medijan operacijskog vremena iznosio 70 minuta (p=0,184). Medijan duljine hospitalizacije bio je 2 dana za obje skupine (p=0,951). Medijan vrijednosti ljestvice Lysholm za promatrane skupine bio je 86,5 i 84,5 (p=0,651), a ljestvice IKDC 81,05 i 81,6 (p=0,986). Poznavajuci stetne ucinke meniskektomije, tehnika popravka meniska je dugorocnije bolji odabir i trebala bi se provoditi kadgod je to moguce. Obje tehnike (tehnika postavljanja savova i tehnika fiksacije meniska strelicama) su sigurne i uspjesne u lijecenju ruptura meniska u djece, bez znacajnijih komplikacija te s dobrim dugorocnim rezultatima. Kljucne rijeci: Menisk; Popravak meniska; Djeca; Strelice za menisk; Sivanje; Artroskopija