外侧盘状半月板损伤关节镜下部分切除成形术与附加缝合术疗效比较  

Comparison of clinical results for arthroscopic repairing lateral discoid meniscus tear between contouring partial menisectomy and additional suture

作　　者：李中正 王玉聪 方镇洙 

机构地区：[1]宁波市第九医院骨科,浙江315020

出　　处：《中国骨与关节损伤杂志》2015年第10期1055-1057,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 比较外侧盘状半月板损伤关节镜下部分切除成形术与附加缝合术的临床疗效。方法 自2010-04—2014-05共诊治外侧盘状半月板损伤35例,采用关节镜下部分切除成形术治疗20例（单纯组）,采用关节镜下部分切除成形附加缝合术治疗15例（附加组）。手术前后采用Lysholm评分评价膝关节功能,末次随访时采用主观症状Ikeuchi标准评价治疗效果。结果 单纯组获得平均39.7（5-46）个月随访,附加组获得平均41.3（5-46）个月随访。附加组术前症状持续时间明显长于单纯组,差异有统计学意义（t=3.651,P=0.025）。附加组损伤类型中复合撕裂（Ahn等方法分类为Ⅶ型）例数明显高于单纯组,差异有统计学意义（P=0.005）。末次随访时,2组Lysholm评分较术前明显提高,但2组间比较差异无统计学意义（t=1.739,P=0.140）。Ikeuchi临床评估：单纯组优15例,良3例,可2例,优良率90.0%;附加组优10例,良2例,可2例,差1例,优良率80.0%;2组优良率比较差异无统计学意义（P=0.120）。结论 外侧盘状半月板损伤行关节镜下半月板部分切除成形术与附加缝合术的治疗效果满意。行半月板部分切除成形附加缝合术患者术前症状持续时间较长,损伤多为复合撕裂类型。Objective To compare the clinical results of the arthroscopic treating lateral discoid meniscus tear between contouring partial menisectomy group and the additional suture group.Methods Thirty five cases of lateral discoid meniscus tear were treated between April 2010 and May 2014,all cases were arthroscopically treated.Twenty cases underwent contouring partial menisectomy（simple group） and fifteen cases underwent contouring partial menisectomy and additional suture repair（additional group）.Lysholm score system was applied and the scores of two groups before and after operation were compared.At last follow-up the Ikeuchi standard was used to evaluate the treatment effect.Results The simple group cases were followed up for 5-46 months with an average of 39.7 months,the additional group cases were followed up for 5-46 months with an average of 41.3 months.The mean duration of the symptoms in additional group was significant longer than simple group,showing significant difference（t =3.651,P =0.025）.In additional group,the cases of complex tear（The type wasⅦ according to Ahn classification） was more than simple group,showing significant difference（P =0.005）.At last follow-up,the Lysholm score of two groups was significantly improved,but showing no significant difference（t =1.739,P =0.140）.Based on Ikeuchi＇s grading：in simple group,the results were excellent in 15 cases,good in 3,and fair in 2; in additional group,the results were excellent in 10 cases,good in 2,fair in 2 and poor in 1; the excellent and good rate was 80.0%,but showing no significant difference（P =0.120）.Conclusion The lateral discoid meniscus tear treated by contouring partial menisectomy and additional suture in arthroscopic can obtain good results.The contouring partial menisectomy and additional suture repair cases had a significant longer duration of symptoms,and the damage type was mostly complex tear.

关 键 词：外侧盘状半月板损伤 部分切除成形术 缝合术 关节镜 

分 类 号：R684.7[医药卫生—骨科学]