Comparison of new and old all-inside suture devices in meniscal cyst formation rates after meniscal repair
Comparison of new and old all-inside suture devices in meniscal cyst formation rates after meniscal repair
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DOI：
10.1007/s00264-022-05375-4
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发表时间：
2022-03-15
影响因子：
2.7
通讯作者：
Nakamura, Hiroaki
中科院分区：
文献类型：
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作者：
Kinoshita, Takuya;Hashimoto, Yusuke;Nakamura, Hiroaki
目的比较采用新型全内缝合装置（N组）和旧全内缝合装置（O组）修复半月板撕裂后磁共振成像（MRI）证实的囊肿形成率。方法2008年10月至2017年7月，89例连续94例半月板患者诊断为半月板撕裂，采用全内缝合装置进行关节镜下半月板修复。其中5名患者在12个月内失去随访，被排除在研究之外。其余89例半月板患者随访至少12个月，纳入本回顾性队列研究。旧的全内缝合装置（FasT-Fix, Ultra FasT-Fix）使用到2012年12月，而新的全内缝合装置（FasT-Fix 360）从2013年1月起使用。术后12个月在t2加权脂肪抑制MRI上检测半月板囊肿。采用多元logistic回归分析确定与使用新型全内缝合装置和囊肿形成相关的人口学和临床因素。结果N组和O组分别有36例和53例半月板。O组半月板囊肿发生率（53 / 14,26.4%）明显高于N组（36 / 2,5.56%）（P = 0.012）。O组2例患者有症状性囊肿需要切除。多因素logistic分析显示，与旧的全内缝合器相比，使用新型全内缝合器后囊肿形成风险显著降低（优势比= 0.139;P = 0.04）。结论采用新型全内缝合装置修复半月板撕裂后mri确认的囊肿成形率明显低于老式全内缝合装置，提示使用低姿态装置可降低半月板撕裂修复后的囊肿成形率。
Purpose We compared the magnetic resonance imaging (MRI)-confirmed cyst formation rate after meniscal tear repair using a new all-inside suture device (N group) versus the older all-inside suture device (O group). Methods Between October 2008 and July 2017, 94 consecutive menisci of 89 patients were diagnosed with meniscal tears and underwent arthroscopic meniscal repair using the all-inside suture device. Five of these patients were lost to follow-up within 12 months and were excluded from the study. The remaining 89 menisci were followed up for at least 12 months and were included in this retrospective cohort study. Older all-inside suture devices (FasT-Fix, Ultra FasT-Fix) were used until December 2012, while the new all-inside suture device (FasT-Fix 360) was used from January 2013 onwards. Meniscal cysts were detected on T2-weighted fat-suppressed MRI at 12 months postoperatively. Multiple logistic regression analysis was used to identify demographic and clinical factors associated with the use of the new all-inside suture device and cyst formation. Results In total, 36 and 53 menisci were included in the N and O groups, respectively. The incidence of meniscal cysts was significantly greater in the O group (14 out of 53, 26.4%) than in the N group (two out of 36, 5.56%) (P = 0.012). Two patients in the O group had symptomatic cysts that required removal. Multivariate logistic analyses showed that the cyst formation risk significantly decreased after using the new all-inside suture device than the older all-inside suture devices (odds ratio = 0.139; P = 0.04). Conclusions The MRI-confirmed cyst formation rate after meniscal tear repair was significantly lower using the new than the older all-inside suture devices, indicating that the use of a low-profile device may decrease the cyst formation rate.