RU2368343C1 - Method of tenomyoplastic fixation of kneecap by means of arthroscopic equipment - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology. Access in knee joint is realised by standard injections - insidewards and outsidewards of kneecap at the level of its lower pole, arthroscope is introduced. Preliminarily outer capsulotomy and tenomyotomy of lateral vastus muscle are performed hypodermically. Through skin minipunctures on internal surface of joint under control of arthroscope sutures are applied on joint capsule by needle, forming duplication. Medial vastus muscle is sewn to kneecap periosteum by 2 "П"-shaped sutures.

EFFECT: method is low-invasive and allows to reach reliable fixation of kneecap due to restoring of medial vastus muscle function - natural kneecap stabiliser.

1 ex, 2 dwg

Description

The invention relates to medicine, namely to methods for surgical treatment of diseases and consequences of injuries of the musculoskeletal system, leading to instability of the patella.

A known method of combined tenomyoplastic fixation of the patella, which consists in fixing the patella with a tendon-muscle complex, cut from the medial surface of the knee joint with the transition to the medial broad muscle of the thigh (1).

The disadvantages of the method are increased invasiveness and high complexity of surgical intervention.

A known method of tenomyoplastic fixation of the patella using arthroscopic technique. The essence of this method is to form a duplicate capsule of the knee joint by applying 3 sutures to the capsule through mini-punctures of the skin along the inner surface of the joint under the control of an arthroscope (2).

The disadvantage of this method is the low effectiveness of the treatment, namely the occurrence of repeated dislocation of the patella due to overstretching of the capsule of the joint and the lack of toning of the medial broad muscle of the thigh. This method is taken as a prototype.

The aim of the invention is to increase the efficiency of treatment of patients with recurrent dislocation of the patella by ensuring reliable fixation of the patella.

This goal is achieved by toning the medial broad muscle of the thigh by suturing it with two U-shaped sutures to the periosteum of the patella.

Comparison of the proposed method with others known in the field of medicine, showed its compliance with the criteria of the invention.

The invention is illustrated by drawings.

Figure 1 and figure 2 presents the stages of the operation of the proposed method.

The method is as follows: access to the knee joint is carried out from standard injections inwards and outwards from the patella (1) at the level of its lower pole, an arthroscope is inserted, an external capsulotomy and tenomyotomy of the lateral broad muscle of the 6th nucleus are performed subcutaneously (2). Through mini-punctures of the skin along the inner surface of the joint under the control of an arthroscope, three U-shaped sutures are placed on the joint capsule (3) with a needle, forming a duplicature (4), then the medial broad muscle of the thigh (5) is sutured to the periosteum of the patella with two U-shaped sutures (6) . Sutures are immersed under the skin.

The fundamental difference between the proposed method and the method of A.F. Krasnov is the minimally invasive technique that avoids the development of a pronounced adhesive process, as well as the restoration of the function of the medial broad muscle of the thigh - the only active stabilizer of the patella.

The advantage of the proposed method over the prototype is the additional toning of the medial broad muscle of the thigh by suturing it with two U-shaped sutures to the periosteum of the patella in order to restore its function - active fixation of the patella in the correct position.

Clinical example

Patient E., 23 years old, was admitted to the clinic of traumatology and orthopedics GOU VPO SamGMU September 3, 2006 with a diagnosis of recurrent external dislocation of the right patella. The medical history No. 12814/418. From the anamnesis it is known that the first dislocation of the patella occurred in 2004 during jogging. Treated conservatively. Dislocation recurred in 2005 and 2006. Regarding this relapse, she turned to the clinic. On September 5, 2006, an operation was performed according to the developed method — tenomyoplastic fixation of the right patella using arthroscopic technique. An examination of February 27, 2007 revealed: the range of motion in the right knee joint is complete, the joint is stable, the symptom of the anterior drawer is negative.

The technical result. The use of additional toning of the medial broad muscle of the thigh in order to restore its function - active fixation of the patella in the correct position under the control of arthroscopic technology creates optimal conditions for surgery without opening the joint, which reduces trauma, reduces immobilization time, shortens the hospital bed, and facilitates postoperative rehabilitation.

Used Books

1. USSR Copyright Certificate No. 683730, M.cl. A61B 17/00, 1978.

2. Yamamoto, R.K .: Arthroscopic Repair of the medical Retinaculum and capsule in acute patellar dislocation. Arthroscopy 2, 125-131 (1986).

Claims (1)

The method of tenomyoplastic fixation of the patella, consisting in the use of arthroscopic technique, creating a duplicate capsule of the knee joint, characterized in that it additionally tones the medial broad muscle of the thigh by suturing it with 2 U-shaped sutures to the periosteum of the patella.

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