关节镜下清理并半月板切除治疗合并膝骨关节炎的半月板损伤  

Arthroscopic debridement and meniscectomy in treatment of meniscus injury combined with osteoarthritis

作　　者：徐大启[1] 陈华斌[1] 赵浩[1] 瞿瑾[1] 李雄[1] 孙德毅[1] 邱续强[1] 吕红斌[1] Da-qi Xu;Hua-bin Chen;Hao Zhao;Jin Qu;Xiong Li;De-yi Sun;Xu-qiang Qiu;Hong-bin Lü(Department of Sports Medicine and Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China)

机构地区：[1]中南大学湘雅医院运动医学科(中南大学运动医学研究中心),湖南长沙410008

出　　处：《中国内镜杂志》2017年第5期93-96,共4页China Journal of Endoscopy

摘　　要：目的探讨关节镜下清理并半月板切除治疗合并早、中期膝关节骨关节炎(KOA)的中、重度半月板损伤的疗效。方法选取2011年10月-2014年10月该科156例合并有早、中期KOA的中、重度半月板损伤患者,行关节镜下清理并半月板切除术。术前对所有患者行Lysholm膝关节功能评分,常规行膝关节正侧位、髌骨轴位、双下肢全长站立位X片和患膝磁共振成像(MRI)检查,明确KOA诊断和临床分期以及半月板损伤诊断和分级。所有患者均在全麻下行关节镜下关节清理并半月板切除术。术后积极行患肢康复训练,术后7~10天出院,出院后佩戴护膝负重行走。采用门诊复诊或电话方式对患者进行随访。结果所有患者均无围手术感染、化脓性关节炎等严重围手术期并发症;术后随访6~12个月,平均10.9个月。Lysholm膝关节功能评分术后(87.3±7.9)明显优于术前(67.5±4.9)(P<0.05)。结论关节镜下清理并半月板切除治疗合并早、中期KOA的中、重度半月板损伤,创伤小、恢复快、近期疗效良好。Objective To investigate the effect of arthroscopic debridement and meniscectomy in treatmentof moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage.Methods156cases diagnosed with moderate or severe meniscus injury combined with knee osteoarthritis in early or middlestage were collected from October2011to October2014.Lysholm knee score and preoperative examinationssuch as anteroposterior,lateral,axial radiographs,the standing full leg length X-ray film and MRI scan of the kneewere recommended to definitively understand the osteoarthritis staging and meniscus injury grading.All patientswere treated with arthroscopic debridement and meniscectomy.After operation,physical rehabilitation exercisesand regular clinical follow-up were carried out as planned.The Lysholm knee score data from preoperation andterminal follow-up was statistical analyzed.Results No patient experienced any perioperative and postoperativecomplications.Statistical analysis showed that the Lysholm knee score of postoperation was significantly higherthan that of preoperation[(87.3±7.9)vs(67.5±4.9),P<0.05).Conclusion Arthroscopic debridement andmeniscectomy in treatment of moderate or severe meniscus injury combined with knee osteoarthritis in early ormiddle stage,gains beneficial effects for its minimal invasion and quick recovery.

关 键 词：半月板损伤 骨关节炎 关节镜 半月板切除 

分 类 号：R684[医药卫生—骨科学]