关节镜辅助下的同种异体半月板移植(附4例术后20个月以上随访报告)  

Arthroscopy-assisted Allograft Meniscus Transplantation (With Report of 4 Cases’ Following up for More Than 20 Months)

作　　者：余家阔[1] 于长隆[1] 敖英芳[1] 龚熹[1] 江东[1] 谢兴[1] 张继英[1] 王彦明[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100083

出　　处：《中国运动医学杂志》2007年第3期261-262,263-265,I0004,I0005,共7页Chinese Journal of Sports Medicine

基　　金：北京大学医学部"985"工程二期建设项目

摘　　要：目的:介绍同种异体半月板移植并总结4例关节镜辅助下的同种异体半月板移植的初步临床效果。材料和方法:2005年6月～7月,4例半月板切除术后的患者接受关节镜辅助的同种异体半月板移植手术,其中男性3例、女性1例,平均年龄30.78±7.71岁(21.5～38.5岁)。3例内侧半月板移植,1例外侧半月板移植。随访采用症状询问,体征检查,IKDC、Lysholm和Tegner评分及KT2000测量关节稳定性的方法。4例患者均每半年进行一次X线片及MRI检查,分别观察膝关节的关节间隙改变及移植半月板状态。对所得结果,因病例只有4例,故只进行数据描述,不进行统计学分析。结果:对4例患者均进行了平均21.80±0.81(20～22)个月的随访。所有患者随访时关节活动度均正常,均无明显的膝关节疼痛和肿胀,原来长时间活动后被切除半月板的间室不适完全消失。患者可以胜任日常活动和体育锻炼,无并发症出现。IKDC、Lysholm、Tegner评分均较术前明显提高。KT2000测量发现术后膝关节的稳定性有所改善。X线片检查提示术后患者关节间隙无明显变化。每半年一次的MRI检查提示移植半月板术后1年时替代存活已经很好。结论:关节镜辅助下的同种异体半月板移植安全可行,半月板移植可缓解半月板切除后出现的关节疼痛、肿胀等症状,促进关节功能恢复并使膝关节的稳定性有所改善。Objective To introduce the allograft meniscus transplantation and evaluate the primary clinic outcome of arthroscopy - assisted meniscus allograft transplantation in 4 patients with meniscectomy. Methods From June to July of 2005, 4 arthroscopy - assisted allograft meniscus transplantations were performed in 4 patients with meniscectomy. Among them,there were 3 males and 1 female with an average age of 30.78± 7.71 years（21.5 - 38.5 years）, and 3 medial menisci and 1 lateral meniscus transplantations. Symptoms, physical examination, IKDC, Lysholm and Tegner scores, and KT2000 test were used to evaluate the clinic outcome. Every 6 months post operation, the joint space and the status of allograft meniscus was observed with x - ray and MRI for each patient. Because of the limitation of the number of cases, description of the results was used in this study instead of the statistic analysis. Results All of the 4 patients were followed up for an average of 21.80 ±0.81 months （20- 22 months） after transplantation. No complications, normal knee range of motion （ROM）, absence of knee pain and effusion, and disappearance of the discomfort within the meniscectomy compartments after prolonged activity during following up were found in all patients. The patients were compe tent of daily life and sports activity. The IKDC, Lysholm and Tegner scores were significantly increased. KT- 2000 measurement showed the improved stability of the meniscus transplanted knees. The narrowing of joint space was not obvious, and MRI showed that the vicariousness and livability of the allograft menisci appeared within 1 year post operation. Conclusions The safety and feasibility of the arthroscopy assisted allograft meniscus transplantation were approved. Knee pain, knee effusion and joint stability and function were improved after arthroscopicassisted allograft meniscus transplantation.

关 键 词：半月板 同种异体移植 关节镜 膝关节 

分 类 号：R687[医药卫生—骨科学]