非创伤性半月板损伤关节镜下观察分析  

Characteristics of non-traumatic meniscus injury observed under the arthroscopy

作　　者：李志昌[1] 林剑浩[1] 倪磊[1] 

机构地区：[1]北京大学人民医院骨关节科,100044

出　　处：《中华骨科杂志》2015年第8期813-818,共6页Chinese Journal of Orthopaedics

摘　　要：目的总结不同年龄段患者非创伤性半月板损伤的关节镜下特点。方法按照纳入标准：（1）MRI确诊半月板Ⅲ度损伤，（2）且有半月板损伤症状，（3）无明确急性外伤史和急性症状，（4）保守治疗无效，（5）在手术中确证为半月板损伤。纳入2012年全年全部非创伤性半月板损伤患者，以45岁为界分为两组。术前采集基本信息、症状、体征及Lysholm评分，术中记录半月板损伤的部位、类型、伴发损伤及手术方式。应用SPSS19．0（SPSS公司，美国）统计软件包进行统计分析，统计不同年龄段患者的发病频数，对不同年龄段患者的性别、患侧（左或右）、半月板损伤类型以及伴发损伤情况的比较采用x^2检验。结果共纳入患者201例，发病年龄呈双峰分布（20岁和60岁）。年轻患者外侧半月板损伤发生比例更高（单纯外侧半月板损伤占56．10％），而中老年患者则相反（单纯内侧半月板损伤占66．90％）。年轻患者内侧半月板损伤以纵行撕裂（27．80％）、鸟嘴样撕裂（38．90％）和水平撕裂（27．80％）为主；而中老年患者则以鸟嘴样撕裂（20．60％）、水平撕裂（27．20％）、根部损伤（19．10％）和复杂损伤（31．60％）为主。在外侧半月板，年轻患者以鸟嘴样撕裂（45．50％）为主，复杂损伤也达22．70％；而中老年患者中70．20％为复杂损伤。年轻患者中前十字韧带损伤（34．15％）、外侧盘状半月板（21．95％）和半月板囊肿（9．76％）的发生率较高，而中老年患者则大多伴存软骨损伤（81．25％）。结论年轻患者非创伤性半月板损伤更多发生在外侧半月板，更多伴发前十字韧带损伤、外侧盘状半月板和半月板囊肿，而中老年患者则更多发生在内侧半月板，更多伴发软骨损伤；且两组患者非创伤性半月板损伤的类型各有不同。Objective To discuss the characteristics of non-traumatic meniscus injury in patients with different age observed under the arthroscopy. Methods All non-traumatic meniscus injury patients operated during 2012 were included. The name, age, symptoms, signs, Lysholm score before surgery, meniscus injury location, type, and concomitant damage were collected. The inclusive criteria were 1） Ⅲ degree meniscus tear confirmed by MRI, 2） typical symptom of meniscus injury 13） no acute symptom and history of acute injury, 4） conservative treatment failed, 5） and confirmed Subsequently by the surgery. SPSS19.0 （SPSS Inc., USA） was used for statistical analysis. Disease frequencies were calculated for different ages in patients, and gender, disease side （left or right）, the type of meniscus injury and the concomitant injury in patients Of different ages were compared with the chi square test. Results All the 201 patients were divided into two groups due to whether the patients were older than 45 years. The age of surgery was him0dai distribution （20 yrs and 60 yrs）. There were more lateral meniscus tears in the younger group（merely LM 56.10%）, and more medial meniscus tears in the older group（merely MM 66.90%）. The major type of medial meniscus tear in young patients were longitudinal （27.80%）, beak sample tear（38.90%） and horizontal tear（27.80%）; in old patients the main type were beak sample tear （20.60%）, horizontal tear（27.20%）, tear of root （19.10%） and complicated tear （31.60%）. But in lateral meniscus, there were more beak sample tear （45.50%） and complicated tear （22.70%） in young pa- tients, and more than 70% were complicated tear in old patients. There were more ACL tear（34.15%）, discoid lateral meniscus （21.95%） and cyst of menisci （9.76%） in young patients, but more cartilage injury （81.25%） in the old patients. Conclusion Non-traumatic meniscus tear in younger patients happened more in lateral meniscus, with more concomitant ACL t

关 键 词：半月板 胫骨 创伤和损伤 年龄组 关节镜检查 

分 类 号：R687.4[医药卫生—骨科学]