关节镜下打结技术
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• Knots are constructed by tying the loop limb around the post limb (Fig. 1)
FIGURE 1. Loop and post configuration
Arthroscopic Knot Pushers
• An arthroscopic knot pusher is a device used to advance the loop down the post limb into the joint to create the knot.
Arthroscopic knot typing
a instruction Manual
Zhijie xi,MD
The Department of Trauma and Hand Surgery The First Affiliated Hospital of university of Guangxi Traditional Chinese Medicine
• double-hole knot pushers and double diameter knot pushers like the Arthrex 6th Finger (Arthrex, Naples, FL). Doublediameter knot pushers provide better loop security compared to standard single-hole knot pushers
increased by the length of the contact between the loop limb and the post limb
• slack between the individual throws in each knot to maximize
loop security
• The goal of knot tying is to approximate tissue under tension and maintain the tissue in apposition until biologic repair and healing can occur
• It is imperative for all surgeons to learn and use knot-tying techniques that minimize the chance of knot failure
• With the popularity of arthroscopic surgery, the number of used arthroscopic knots and the number of surgeons using these knots has increased
Knot Tying PrinciplesLeabharlann Knot Terminology
• post limb (also commonly known as the axial limb)
• loop limb (also commonly known as the wrapping limb, working end, running end, or free end)
Arthrex knot pushers. A. Single-hole, B. Double-hole, C. 6th Finger
FIGURE 3. Mitek knot pushers. A. Single-hole, B. Double-hole, C. Slotted
double-hole knot pushers and double diameter knot
Knot Tying Principles
• Knot security friction, internal interference, and slack
between throws
• Friction is inherent to the suture material • Internal interference the configuration of the knot and
Introduction
• An increasing number of surgeons are performing arthroscopic surgery in the knee to repair meniscal tears and in the shoulder to repair rotator cuff or labral tears
• The surgeon must sequentially construct the knot outside the joint and then pass the knot into the joint through small cannulas
• Tying arthroscopic knots is technically demanding and requires considerable practice
• slippage can lead to failure of tissue apposition
Knot failure
four different processes of knot failure ➢knot slippage and loosening ➢suture breakage ➢tissue failure ➢suture anchor pullout from bone ➢through suture breakage
• Many are also performing capsular shifts to treat instability.
• Essential to these procedures is the ability to tie arthroscopic knots to approximate intraarticular
FIGURE 1. Loop and post configuration
Arthroscopic Knot Pushers
• An arthroscopic knot pusher is a device used to advance the loop down the post limb into the joint to create the knot.
Arthroscopic knot typing
a instruction Manual
Zhijie xi,MD
The Department of Trauma and Hand Surgery The First Affiliated Hospital of university of Guangxi Traditional Chinese Medicine
• double-hole knot pushers and double diameter knot pushers like the Arthrex 6th Finger (Arthrex, Naples, FL). Doublediameter knot pushers provide better loop security compared to standard single-hole knot pushers
increased by the length of the contact between the loop limb and the post limb
• slack between the individual throws in each knot to maximize
loop security
• The goal of knot tying is to approximate tissue under tension and maintain the tissue in apposition until biologic repair and healing can occur
• It is imperative for all surgeons to learn and use knot-tying techniques that minimize the chance of knot failure
• With the popularity of arthroscopic surgery, the number of used arthroscopic knots and the number of surgeons using these knots has increased
Knot Tying PrinciplesLeabharlann Knot Terminology
• post limb (also commonly known as the axial limb)
• loop limb (also commonly known as the wrapping limb, working end, running end, or free end)
Arthrex knot pushers. A. Single-hole, B. Double-hole, C. 6th Finger
FIGURE 3. Mitek knot pushers. A. Single-hole, B. Double-hole, C. Slotted
double-hole knot pushers and double diameter knot
Knot Tying Principles
• Knot security friction, internal interference, and slack
between throws
• Friction is inherent to the suture material • Internal interference the configuration of the knot and
Introduction
• An increasing number of surgeons are performing arthroscopic surgery in the knee to repair meniscal tears and in the shoulder to repair rotator cuff or labral tears
• The surgeon must sequentially construct the knot outside the joint and then pass the knot into the joint through small cannulas
• Tying arthroscopic knots is technically demanding and requires considerable practice
• slippage can lead to failure of tissue apposition
Knot failure
four different processes of knot failure ➢knot slippage and loosening ➢suture breakage ➢tissue failure ➢suture anchor pullout from bone ➢through suture breakage
• Many are also performing capsular shifts to treat instability.
• Essential to these procedures is the ability to tie arthroscopic knots to approximate intraarticular