Objective: To explore the application value and operation skills of arthroscopic automatic reverse guide wire passer (hereinafter referred to as wire passer) in the posterior meniscus root reconstruction.
Methods: Between August 2015 and December 2020, 36 patients with posterior meniscus root tears were admitted. There were 16 males and 20 females, with an average age of 46 years (range, 26-66 years). There were 15 cases of sports injury and 21 cases of degenerative injury. The disease duration was 3-180 days, with a median of 28 days. The posterior root of the medial meniscus was injured in 29 cases, and the posterior root of the lateral meniscus was injured in 7 cases. The preoperative Lysholm score of the knee joint was 47.6±3.9, and the International Knee Score Committee (IKDC) score was 39.3±3.0. The meniscus was sutured by using wire passer under arthroscopy. During operation, the suture operation was evaluated according to the self-defined evaluation standard. Lysholm score and IKDC score were used to evaluate knee joint function.
Results: All meniscuses were sutured successfully by using wire passer. The operation time of suture was 5-15 minutes, with an average of 10 minutes. According to the self-defined evaluation standard, the suture operation was scored as 0-10, with an average of 5. After operation, except for 2 cases of incision fat liquefaction, the incisions of the other patients healed by first intention. All patients were followed up 1-3 years, with an average of 1.5 years. The Lysholm score was 88.2±2.1 and the IKDC score was 51.7±2.3 at 1 year after operation, showing significant difference when compared with preoperative ones ( P<0.001). Fifteen cases underwent MRI re-examination, the results showed that the continuity and integrity of the posterior root had been restored.
Conclusion: Under arthroscopy, the wire passer for the posterior meniscus root reconstruction has the advantages of simple operation, reliable suture quality, and shorter operation time.
目的: 探讨关节镜自动反向导引过线器（以下简称过线器）在半月板后根重建中的应用价值与操作技巧。.
方法: 2015年8月—2020年12月，收治36例半月板后根部撕裂患者。男16例，女20例；年龄26～66岁，平均46岁。损伤原因：运动伤15例，退变性损伤21例。病程3～180 d，中位病程28 d。内侧半月板后根损伤29例，外侧半月板后根损伤7例。术前膝关节Lysholm评分为（47.6±3.9）分，国际膝关节评分委员会（IKDC）评分为（39.3±3.0）分。关节镜下采用过线器缝合重建半月板。术中参照自定评价标准评定缝合操作情况，术后采用Lysholm评分及IKDC评分评价膝关节功能。.
结果: 所有半月板采用过线器均顺利完成缝合，缝合操作时间5～15 min，平均10 min。根据自定评价标准，缝合操作评分0～10分，平均5分。术后除2例切口发生脂肪液化外，其余患者切口均Ⅰ期愈合。患者均获随访，随访时间1～3年，平均1.5年。术后1年Lysholm评分为（88.2±2.1）分，IKDC评分为（51.7±2.3）分，与术前比较差异均有统计学意义（ P<0.001）。15例行MRI复查，示半月板后根部连续性及完整性恢复。.
结论: 关节镜下采用过线器缝合半月板后根部，具有操作简便、缝合质量可靠以及手术时间较短等优势。.
Keywords: Meniscus; arthroscopy; posterior root tear; wire passer.