慢性反应性滑膜炎在前交叉韧带重建和带式缝合增强患者中的应用。

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-02-01 DOI:10.1016/j.jcot.2024.102884

Anant Joshi , Aashiket Sable , Sajeer Usman , Bhushan Sabnis , Vaibhav Bagaria

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引用次数: 0

摘要

关节镜下前交叉韧带重建（ACLR），采用内支具和带式缝合线（TTS）增强，由于其生物力学优势而受到欢迎。然而，对慢性反应性滑膜炎的担忧已经出现，这可能导致移植物失败和需要翻修手术。本研究的目的是确定tts增强ACLR后慢性反应性滑膜炎的患病率。材料和方法：对2019年由一名外科医生使用FiberTape或SutureTape增强装置进行关节镜下ACL重建的84例患者进行回顾性分析。结果：在分析的84例患者中，17例在术后3-45个月内出现至少两种或两种以上症状，包括持续不稳定、膝关节疼痛、肿胀、僵硬和局部体温升高。所有患者均需要二次手术，包括滑膜切除术和胶带移除（8例）或ACLR翻修（9例）。术中组织病理学分析证实为异物反应性滑膜炎。二次手术一年后，17个膝关节均获得满意的结果。所有患者都没有经历二次手术前的疼痛、肿胀或不稳定。结论：84例有症状的ACLR患者中，有17例（20.2%）出现异物滑膜炎。虽然本研究没有建立胶带缝合与滑膜炎发展之间的直接因果关系，但它强调了对即将发生的反应性滑膜炎作为并发症保持警惕的重要性，因为膝关节可能暴露于异物。证据等级：四级（回顾性病例系列，无对照组）。

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Chronic reactive synovitis in patients undergoing ACL reconstruction and augmentation with tape-type sutures

Introduction

Arthroscopic Anterior Cruciate Ligament Reconstruction (ACLR) with internal bracing and augmentation using tape-type sutures (TTS) has gained popularity due to its biomechanical advantages. However, concerns have emerged regarding chronic reactive synovitis, which can lead to graft failure and the need for revision surgery. The purpose of this research is to determine the prevalence of chronic reactive synovitis after TTS-reinforced ACLR.

Materials and methods

A retrospective review was conducted on a series of 84 patients who underwent arthroscopic ACL reconstruction with FiberTape or SutureTape augmentation, performed by a single surgeon in the year 2019.

Results

Of the 84 patients analyzed, 17 presented with at least two or more symptoms, including persistent instability, knee pain, swelling, stiffness, and local rise in temperature, within 3–45 months post-surgery. All required secondary surgery, either for synovectomy, and tape removal (8 cases) or revision ACLR (9 cases). Intraoperative histopathological analysis confirmed the diagnosis of reactive synovitis due to foreign body reaction. One year after the secondary surgery, all 17 knees showed satisfactory results. None of the patients experienced the pain, swelling, or instability that they had before the secondary surgery.

Conclusion

Foreign body synovitis was found in 17 symptomatic patients out of 84 (20.2 %) who underwent ACLR with TTS reinforcement one year. While this study does not establish a direct causal link between tape-type sutures and the development of synovitis, it emphasizes the significance of remaining vigilant for impending reactive synovitis as a complication, given the potential exposure of the knee to foreign body material.

Level of evidence

Level IV (Retrospective case series without a comparison group)

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.