There are medial and lateral half-moon-shaped bones on the articular surface of the tibia, called menisci.

Its edge is thicker and tightly connected to the joint capsule, while its center is thin and free.

The normal meniscus has the function of increasing the depression of the tibial condyle and padding the internal and external femoral condyle to increase joint stability and buffer shock. It protects the femur and tibia from direct impact.

When we wear shoes, we usually put an insole on them to make them more comfortable.

After meniscus injury, the main symptom is knee joint pain, and some patients have snapping and joint locking.

If not treated in time, the damaged meniscus will continue to wear away the cartilage of the knee joint, and our cartilage has no regeneration ability. The direct consequence of cartilage damage is to accelerate the occurrence of osteoarthritis. In severe cases, lameness or flexion and extension dysfunction may occur.

Seriously affects the quality of life.

Therefore, the role of the meniscus is very important.

Except for older people, and even for older people, the meniscus should be preserved as much as possible.

After all, the meniscus is just an insole, not the actual insole we wear now. If it is inappropriate or worn out, we can just spend a few dollars, even tens or even hundreds of dollars to buy a pair and replace it.

Our body is perfect when we are born. Once it is damaged, the mother who gave you this body is not responsible for replacing the original parts, and others cannot help you fully recover.

Therefore, from a medical point of view, the so-called complete recovery is false. It can only be said that it will try its best to help you solve problems such as pain and help you complete the actions you should do in daily activities. Once you are injured, you will never be the same again!

After the meniscus is damaged, there are several ways to resolve the symptoms.

One is to remove it, that is, if the worn insoles are worn on the feet, it is better to throw away the insoles, which may be more comfortable. It is also like walking barefoot when the shoes are full of small stones.

The second is suture. Suture is repair. The torn insole is sewn where it can be sutured. If it is rolled up, the place where the diaphragm meets the foot is flattened. Although it is a bit rotten, it still has the function of protecting the foot.

The third is shaping, also called partial resection, which is a supplement to resection. It means cutting off the parts that should be cut and leaving the parts that should not be cut, which can be used as a buffer zone between the tibia and femur.

Fang Nixin has relatively high requirements for herself, and she is very hesitant at the moment. Although she has not really studied sports medicine, she has read quite a few articles.

According to the current trend and the most advanced thinking, as well as the latest supporting evidence of evidence-based medicine, suturing will bring greater comprehensive benefits to the patient than complete removal.

But here’s the problem. The radial damage is not consistent with the half-moon shape of the meniscus. The plain MRI scan of the knee joint is scanned layer by layer in three levels: coronal plane, sagittal plane, and transverse plane. No.

Obvious damage may not be visible at all.

If she had known that the patient had three ruptures, Fang Nixin would not have forced herself to pull the patient onto the operating table. After all, she was not sure about the effectiveness of the sutures she performed.

Li Dongshan also saw Fang Nixin's hesitation at this moment and looked solemn. He had carefully selected this patient's MRI.

It was just to let Fang Nixin practice her hand first and find out the feeling. Unexpectedly, it directly brought psychological pressure to Fang Nixin.

Biting forceps can bite off the inner edge of the meniscus, but they are not suitable for biting off the entire meniscus.

If the rupture is not severe enough, after biting off the edge of the rupture, the meniscus will not be free and rolled up, and the rest will still be a whole, so it will not cause irritation to the cartilage surface.

This is another reason why plastic surgery can be used for treatment.

But the problem is, after Fang Nixin bit out all the cracks on the edge, when he used the probe hook to explore the meniscus, the meniscus still looked a little loose.

Li Dongshan also noticed.

To sew.

Upon seeing this, Li Dongshan said: "Ni Xin, don't be nervous, take your time. Don't be in a hurry."

There are specialties in the field of medicine. Although Li Dongshan is a professor of orthopedics, his sub-specialty is trauma and fractures. He is more powerful than Professor Zhou Xuanqing, but this does not mean that his attainments in sports medicine will be higher than Lin Hui.

The history of the development of sports medicine is not many years old. He has not kept up with it and has no energy to study it. In fact, he just knows how to read films better than Fang Nixin. This is not a product of their era.

Fang Nixin nodded slowly and said, "Teacher, please prescribe two 0/2 AiSibang sutures for me."

Fang Nixin knew very well that this patient's front horn, body, and posterior horn were damaged. To choose the meniscus suture method, unless you choose a full-joint meniscus suture system, such as Fastfix, otherwise you have to do it at the same time.

There are two suturing methods, from outside to inside and from inside to outside.

The outside-in method can be punctured with a No. 18 lumbar puncture needle or a No. 12 beveled ordinary injection needle. The operation is the simplest, but it is only suitable for the front corners and body, and is not suitable for the back corners.

The inside-out method is better, which is the opposite of outside-in. The needle and thread are inserted from the inside of the joint to the outside of the joint, and knotted and fixed outside the joint.

It can control the needle insertion site of the meniscus within the joint, making the suturing more neat and reliable.

However, the inside-out method requires specialized surgical instruments. When suturing the posterior corners, additional incisions are required and curved baffles are used to protect blood vessels and nerves. It is suitable for injuries to the meniscus body and posterior corners, but is not suitable for suturing the anterior corners.

A stitch of suturing a whole joint costs several thousand, which is too expensive. In addition, suturing the tibial tunnel is too harmful to the human body.

"Let's give another fast-fix injection." If the posterior corner is sutured from the inside out, additional incisions will be made, which will also increase the patient's injuries. At this time, the only way to spend more money is to add more money.

After Li Dongshan listened, he quickly explained to the patient himself.

Because meniscus surgery only requires spinal anesthesia, and the monitor of the mirror is on the patient's head, he can see the whole process. Li Dongshan didn't even speak before he said to himself: "Professor Li, I can see clearly, please."

Please help me sew it up."

"Dr. Zou told me before the operation that the sutures will be better for the future. Just spend more money, it doesn't matter."

"Okay." Li Dongshan received the response and said: "Let's use the two lumbar needles."

Fang Nixin immediately took the lumbar puncture needle and said, "Xiao Lu, come and help me hold the mirror."

Suturing from the outside to the inside naturally requires one person to hold the arthroscope and provide a field of view within the joint. Only in this way can the operation be performed visually.

"Okay, senior sister." Lu Cheng also saw Fang Nixin's confusion at this moment, took the mirror steadily, and adjusted it slightly, making the field of view of the entire arthroscope wider.

Fang Nixin saw this change, but she didn't have the time to think about how Lu Cheng did it. She just used her hand to roughly explore the corresponding position of the patient's meniscus, and then inserted the lumbar puncture needle.

The needle tip broke out of the joint, but did not penetrate into the body of the meniscus.

Obviously, sewing is not that simple.

At this moment, the door of the operating room was opened, and a man walked in. He said with a smile: "I said I asked the roving team where the other set of arthroscopes went, but I didn't expect to find it here."

"Professor Li, your business is getting wider and wider now."
Chapter completed!