关节镜下半月板部分切除术治疗中老年人内侧半月板损伤  

Arthroscopic partial meniscectomy for medial meniscal tear in late middle aged adults

作　　者：刘劲松[1] 李智尧[1] 

机构地区：[1]中国中医科学院望京医院关节四科,北京100102

出　　处：《中国骨伤》2014年第8期631-634,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨关节镜下半月板部分切除术治疗中老年人内侧半月板损伤的临床疗效及其临床价值.方法：自2010年10月至2012年10月,对49例符合纳入标准的膝关节内侧半月板损伤患者,通过关节镜下半月板部分切除术进行治疗.其中男31例,女18例;年龄50～60岁,平均（55.3±2.8）岁;左膝22例,右膝27例.49例平均屈曲角度（116.01±12.03）°.术前膝关节HSS功能评分平均48.73±8.43,Lysholm评分平均63.95±5.45.均采用标准半月板部分切除术,切除损伤部分半月板,遗留前方正常半月板组织.结果：所有手术成功,无严重并发症.术后随访12～36个月,无失访病例.所有患者保持5级肌力,膝关节活动度正常,能完全伸直及完全屈曲.49例平均屈曲角度（136.77±18.56）°,较术前提高（t=17.56,P=0.001）;终末随访膝关节HSS功能评分86～95分,平均90.17±4.10,较术前提高（t=12.65,P=0.001）;Lysholm评分82～91分,平均87.84±5.16,较术前提高（t=13.45,P=0.001）.结论：关节镜下半月板部分切除治疗中老年人单纯内侧半月板损伤疗效优良.严格掌握适应证是保证疗效的前提,精确的手术技术是保证疗效的关键.术后短期内部分患者存在膝关节活动受限,但经过治疗及康复均能完全恢复.Objective：To study the results of arthroscopic partial meniscectomy for medial meniscal tear in late middle-aged adults.Methods：From October 2010 to October 2012,49 patients meeting inclusion criteria were treated with arthroscopic partial meniscectomy for medial meniscal tear.There were 31 males and 18 females,with an average age of （55.3±2.8） years old.There were 22 left knees and 27 right knees.The average flexion angle was （116.01± 12.03）°.The pre-operative HSS Knee Score was 48.73±8.43,and the Lysholm score was 63.95±5.45.The patients were followed up and evaluated.All the patients received a standard surgery,in which the torn tissue was removed,and the anterior part of the meniscus was left in situ.Results：All the surgeries were successful with no serious complications.All the patients were followed up,and the duration ranged from 12 to 36 months.All the patients had 5 degrees of muscle strength.The average flexion angle was （136.77± 18.56）°.There was significant difference between the two angles before operation and after operation.The pre-operative HSS Knee Score was 90.17±4.10,and the Lysholm score was 87.84±5.16.Statistically,the difference between preoperative score and the postoperative score was significant.Conclusion：Arthroscopic partial meniscectomy is a good option for medial meniscal tear in late middle-aged adults.Operative indication is crucial and the excellent surgical technique is also critical for the good clinical outcome.All the patients could get good clinical results,although there are some patients with motion restrictions in the early stage after operation.

关 键 词：半月板 胫骨 膝关节 关节镜 

分 类 号：R687.4[医药卫生—骨科学]