关节镜下腰椎穿刺针钢丝引导PDS缝合治疗完全型盘状半月板损伤  

PDS suture through spinal needle for arthroscopic repair of complete lateral discoid meniscus injuries

作　　者：李小永 谭红略 代朋乙 袁彦浩 LI Xiao-yong;TAN Hong-lue;DAI Peng-yi;YUAN Yan＇hao(Department of Knee Injury,Henan Luoyang Orthopedic and Traumatological Hospital,Luoyang 471002,China)

机构地区：[1]湖南中医药大学,长沙410007 [2]河南省洛阳正骨医院河南省骨科医院,河南洛阳471002

出　　处：《中国矫形外科杂志》2018年第22期2099-2102,共4页Orthopedic Journal of China

摘　　要：[目的]介绍关节镜下修整并腰椎穿刺针钢丝引导PDS缝合治疗膝关节外侧完全型盘状半月板损伤的技术与临床疗效。[方法] 2015年1月～2017年1月,本科收治24例膝关节外侧完全型盘状半月板损伤患者。其中男13例,女11例,年龄11～44岁,平均(27.03±11.31)岁;左膝11例,右膝13例;病程2～8个月,平均(2.54±2.12)个月。依据Watanabe盘状半月板分型,均为完全型。术中采用关节镜下修整,腰椎穿刺针钢丝引导下PDS缝合治疗。术后依据Lysholm评分系统评估膝关节功能。[结果]随访时间12～24个月,平均(16.47±4.46)个月,未发生感染、深静脉血栓及关节黏连等并发症,关节交锁及弹响症状消失。患者术后膝关节功能恢复满意,Lysholm评分由术前的(74.17±8.56)分增至末次随访时的(96.75±4.21)分,差异有统计学意义(t=-15.447,P<0.05)。本组优19例,良5例。[结论]关节镜下半月板成型并腰椎穿刺针钢丝引导PDS缝合治疗外侧完全型盘状半月板损伤,具有创伤小、操作简捷、缝合可靠及费用低廉等优点,是手术治疗完全型盘状半月板损伤可供选择的有效方式之一。[Objective] To introduce the technique and clinical outcomes of PDS suture through spinal needle for arthroscopic repair of complete lateral discoid meniscus injuries. [Methods] A retrospective study was done on 24 patients who underwent surgical treatment for complete lateral discoid meniscus injury from January 2015 to January 2017 in our department, including 13 males （13 knees） and 11 females （11 knees） aged from 11 to44 years with a mean of （27.03±11.31） years. The lesions involved the left knee in II patients and right knee in 13 patients with disease duration from 2 to 8 months, （2.54± 2.12） months on average. According to Watanabe＇s classification, all the 24 knees were graded as complete type. All patients received arthroscopic partial meniscectomy combined with repair by PDS suture through spinal needle outside-in. The knee function was evaluated by Lysholm score. [Results] Duration of follow up lasted for 12 to 24 months with a mean of （16.47±4.46） months. No infection, deep venous thrombosis and knee ankylosis occurred in anyone of them, whereas the symptoms, such as locking and snapping, completely disappeared during the follow-up. All the patients achieved satisfactory functional recovery, associated with a statistically significant improvement in Lysholm scores form （74.17±8.56） preoperatively to （96.75±4.21） at the latest follow up （P〈0.05）. The clinical results were graded as excellent in 19 patients and good in 5 patients. [Conclusion] This technique with PDS suture through spinal needle outside-in takes advantages of minimal invasive surgery, simple manipulation, stable suture fixation, and high cost-effectiveness, and is one of the effective surgical methods for arthroscopic treatment of the complete lateral discoid meniscus injuries.

关 键 词：盘状半月板 PDS缝合 腰椎穿刺针 钢丝 关节镜 

分 类 号：R683.41[医药卫生—骨科学]