Cengiz ŞEN, Mehmet IŞIK, Feridun YUMRUKÇAL, Ali Can ATALAR, Mehmet ERDİL, Ömer F. TAŞER

RapidLoc ﬁksatörü ile menisküs tamiri

Amaç: Menisküs tamirlerinde konvansiyonel dikiş yöntemleri ile oldukça tatminkar sonuçlar elde edilmesine karşın, bu yöntemlerde ameliyat süresi uzun ve komplikasyon oranı yüksektir. Bu çalışmada, RapidLoc ﬁksatörü kullanılarak yapılan menisküs tamirlerinin klinik sonuçları değerlendirildi. Çalışma planı: Çalışmaya RapidLoc ﬁksatörü ile menisküs tamiri yapılan ardışık 57 hasta (hepsi erkek; ort. yaş 24; dağılım 17-33) alındı. Travma ile ameliyat arasında geçen süre ortalama 20 gün (dağılım 7-60 gün) idi. Ortalama yırtık uzunluğu 25 mm (dağılım 10-35 mm) idi. Her bir yırtık için ortalama iki adet (dağılım 1-3) RapidLoc ﬁksatörü kullanıldı. Ön çapraz bağ (ÖÇB) yırtığı olan 30 hastanın 17’sine, menisküs tamiri ile beraber hamstring otogreft ile ÖÇB rekonstrüksiyonu yapıldı; 13 hastaya ise rekonstrüksiyon istemedikleri için sadece menisküs tamiri yapıldı. Hastalar Tegner aktivite skoru, Lysholm skoru ve IKDC (International Knee Documentation Committee) subjektif diz değerlen- dirme formuna göre değerlendirildi. Klinik değerlendirmede Barrett ölçütleri kullanıldı. Ortalama takip süresi 39 ay (dağılım 18-66 ay) idi. Sonuçlar: Menisküs tamiri sırasında tanısal ve cerrahi artroskopiyi içeren toplam ameliyat süresi ortalama 25 dakika (dağılım 15-35 dk) idi. Ameliyat öncesine göre tüm fonksiyonel sonuçlarda anlamlı düzelme görüldü (p

Anahtar Kelimeler:

Artroskopi, Menisküs, tibial, Reoperasyon, Diz yaralanmaları, Ortopedik işlemler

All-inside meniscal repair using the RapidLoc device

Objectives: Although conventional suture techniques yield satisfactory results in the treatment of meniscal ruptures, they are inherent with long operative time and high complication rates. The purpose of this study was to evaluate the results of meniscal repair with the use of the RapidLoc device. Methods: The study included 57 consecutive patients (all males; mean age 24 years; range 17 to 33 years) who underwent meniscal repair with the RapidLoc device. The mean time from injury to surgery was 20 days (range 7 to 60 days). The mean length of meniscal ruptures was 25 mm (range 10 to 35 mm). A mean of two RapidLoc ﬁxators were used for each rupture. Thirty patients had associated anterior cruciate ligament (ACL) rupture; of whom 17 patients underwent ACL reconstruction with hamstring autografts. Thirteen patients refused ACL reconstruction and underwent only meniscal repair. Functional results were evaluated using the Tegner activity score, Lysholm score, and IKDC (International Knee Documentation Committee) subjective knee evaluation form. Clinical assessments were made using the Barrett criteria. The mean follow-up was 39 months (range 18 to 66 months). Results: The mean operation time including diagnostic and surgical arthroscopy was 25 minutes (range 15 to 35 min). Compared to the preoperative scores, all functional scores showed signiﬁcant improvements (p<0.001) with the following increases: Lysholm score from 58.8±13.7 to 93.3±7.7, Tegner activity score from 3.5±1.0 to 6.0±1.6, and IKDC score from 52.8±10.5 to 91.4±4.0. According to the Barrett criteria, meniscal healing was achieved in all the patients. Second-look arthroscopy was performed in one patient due to pain and swelling, which showed an unabsorbed tophat of the RapidLoc device. Conclusion: Our ﬁndings suggest that the RapidLoc meniscal repair device may be an appropriate choice in selected cases because of satisfactory short-term clinical results, ease of applicability, short operation time, and low complication rate.

Keywords:

Arthroscopy, Menisci, Tibial, Reoperation, Knee Injuries, Orthopedic Procedures,

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