| Objective:Meniscuses are important structures in knee joints, they have very important functions. The injury of meniscus is the most common injury in locomotor system. The injured meniscus will disturb the normal function of knee seriously. The principle of meniscal treatment is to save as much normal tissue of meniscus as possible. Meniscal suture is an ideal treatment for meniscal injury. It is a difficult challenge to improve the healing of the lesion. There are several methods to facilitate the healing of the meiscus. It is a new method to suture the injured meniscus with tondon. It was proved in the animal experiment that tondon has a very good compatibility with the meniscal tissue, it will carry in vessels to the lesion to promote the regeneration and it will transfer to meniscal tissue. All these changes will facilitate the healing of the meiscus. We need new instrument in order to develop the new technique. The purpose of our study is to develop a new suit of instrument for meniscal suture with tondon. This suit of instrument will facilitate our operation. And we will authenticate the therapeutic effect of the new technique through its application and our follow-up visit. includs the change of symptoms and physical signs. Sometimes E-MRI is necessary.Method:Based on previous clinical experience and repeted verification, we develop a suit of instrument for meniscal suture with tondon. There are needles, repositor, rasp, measurer and working table in this suit, etc. We make the tondon into suture line guided by stitch at the two ends. The suture line was led into the joint by needls. All of our meniscuses were sutured by the inside-out or/and outside-in technique. Orthosis was used after the operation, and functional rehabilitation was necessary. We compare the pre-operation Lysholm score with the post one, authenticate the therapeutic effect of the new technique through follow-up visit, includs the change of symptoms and physical signs. Sometimes E-MRI is necessary.Result:Part One: Development of the instrumentWe first designed the instruments in paper based on our clinical experience, then we send them to the factory. After the application, we ameliorate our instrument. We have a suit of instrument now, includs needles of different direction and different diameter, repositor for relocating the afloat meniscus, rasp for meniscal freshing, measurer of diameter and working table in this suit, etc.Part Two: Clinical applicationWe have sutured 45 meniscuses with our new technique. One sutrue takes 23 minutes in average. The crevasse is appropriate to be sutured if it is not in the post-horn. In the operation, you must choose the right needles for every crevasse and suture it vertically. All operations were carried out successfully without complication of injury to nerve and vessels. The follow-up visit last from 4 to 24 monthes, all the clinical symptoms have disappeared, includs pain, swelling and locking, etc. One knee still had some swelling 5 months after the operation and it had the ROM of 0°～110°. One another had the ROM of 0°～100°4 months after the operation. All the others had the normal ROM and they can do sports as before the trauma. The pre-operation Lysholm score range from 33 to 73, the average is 53. The Lysholm score range from 73 to 97 a half year after the operation(if not enough, 4 months instead), and the average is 87.8. They are different statistically and our P was lower than 0.01.Conclusion:It is convenient to suture injured meniscuses with our new instruments, it is appropriate for almost every part of meniscus except the post-horn, and it's suit for almost all types of injury. We have broaden the indication of meniscal repair. The meniscus have the strong trend to heal. Patients can recover more quickly. It is an effective method to repair meniscuses with tondon according to our follow-up visit.
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