半月板缝合系统课件.ppt

<p>Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。,Anatomy,Product overview,Instructions for use,Hands-on workshop,Agenda,Meniscal function,Load transmission,负荷转移,Joint stability,稳定关节,Shock absorption,振荡吸收,Joint lubrication,润滑关节,Joint nutrition,营养关节,Anatomy,Crescent-shaped fibrocartilage,新月形纤维软骨组织,Collagen fibers arranged,胶原纤维分布,longitudinally and radially,纵形放射状分布,Triangular in cross section,横切面呈三角型,Meniscal Anatomy,Lateral-circular shaped,Medial-C-shaped,Connected anteriorly by transverse meniscal ligament,在前部由半月板横韧带连接,Direct bony attachments at anterior and posterior horns,前后角骨性连接,Lateral and medial coronary ligaments,内外侧有冠状韧带,Lateral,Medial,Meniscal Anatomy,Anatomy,Three Zones,Red-Red Zone,Red-White Zone,White-White Zone,Meniscal Blood Supply,Location in relationship,to circumference,Anterior 1/3,Middle 1/3,Posterior 1/3,Classification of Tears,TRAUMATIC,创伤性,-Younger patients,-Usually sports related,-More peripheral thus repairable,外围可以修补,-May be associated with ACL,DEGENERATIVE,变性,性,-Older patients,-Complex tears,-Usually not repairable,-Age group typically not suited for repair,Meniscal Tears,Treatment,Partial Menisectomy,Complex degenerative tears,复杂变性撕裂。,Central or radial tears,放射状撕裂,Deformed or irreparable bucket-handle tears,严重桶状裂,Tears of the inner edge of meniscus,半月板内缘撕裂,Preserve stable meniscus to preserve joint function,Treatment-Repair,Factors to consider,因素,Patient age,年龄,Chronicity of injury,是否慢性损伤,Type,location and length of tear,类型、位置、长度,Associated ligamentous injuries,联合损伤,Ideal candidate,理想条件,Young person,年轻,Acute longitudinal peripheral tear,急性纵相外周损伤,1-2cm in length1-2cm,长,Types of Tears,Bucket handle/,vertical longitudinal,Flap,parrot beak/,oblique,Radial/,transverse,Types of Tears,Cleavage/,horizontal,Degenerative,/complex,What Is It?,Rapidloc,Meniscal Repair System,Backstop(PLA),Tophat(PLA/PDS),Panacryl/EthibondSuture,Rapidloc,Implant,RapidLoc PDS,PDS,Tophat,Maintains 80%strength at 6 weeks,10%at 12 weeks,Rapidloc,Meniscal Repair System,27 curved needle 228322,12 curved needle 228321,Straight needle 228320,Rapidloc,Meniscal Repair System,Arthroscopic Pusher,Required-Other pushers do not work.,New Pusher-Cutter,Arthroscopic Pusher-Cutter for RapidLoc,Works as a Knot-Pusher,Cuts suture after tophat is compressed to tissue,Rapidloc,Meniscal Repair System,Delivery System,Existing,Meniscal,Applier,Less Kickback,Surgical Technique,Rapidloc,Surgical Technique,Indicated for bucket-handle lesions in the Vascularized areas of the meniscus.,桶状裂,Preparation of the tear is critical,Freshen the tear with a rasp or shaver.,修整创伤面,Rapidloc,Surgical Technique,Insert the applier through a standard portal,通过标准入路插入填充琦,Through portal alone,Through a cannula,With the aid of the malleable graft retractor,Rapidloc,Surgical Technique,Use needle and silicone tubing to reduce the tear,Rapidloc,Surgical Technique,Pass the needle through the Meniscal substance and into the Pericapsular tissue Posteriorly.,将针穿过半月板穿到关节囊后,Rapidloc,Surgical Technique,Deploy the backstop,展开挡板,Maintain pressure on the gun to prevent kickback,保持压力,Remove needle and applier from joint,撤出针及枪,Rapidloc,Surgical Technique,Pull on the limb of suture to assure capture and fixation of the backstop,推线确保固定牢靠,Rapidloc,Surgical Technique,Using the Arthroscopic pusher slide the knot and Tophat down to the surface of the tissue,用推结器将结推到半月板,Use a pull/push action,Pull on the suture with slightly more tension to avoid slack in the suture,Rapidloc,Surgical Technique,Cut the limb of suture,剪线,Repeat with additional implants,相同方法植入,Probe to assure tear is stable,探钩确认固定牢靠,Rapidloc,Why is it Better?,Why Is It Better?,Flexibility,More choices for the surgeon,No measuring/no fixed length,One implant,Dependable compression,Controlled by surgeon,Why Is It Better?,Flexible fixation,柔性固定,Suture across tear versus rigid material,like the meniscus,Minimize Articular cartilage damage,关节软骨损伤最小化,TOPHAT pivots and lies flush against tissue,</p>