关节镜辅助治疗急性后内侧角损伤的疗效观察  

Clinical Observation of Arthroscopic Assisted Treatment of Acute Posterior Medial angle Injury

作　　者：钱春生[1] 刘家能 付昌马[1] Qian Chunsheng;Liu Jianeng;Fu Changma(Department of Orthopedics,Hefei Third People's Hospital,Hefei 230022,China)

机构地区：[1]合肥市第三人民医院骨科安徽医科大学合肥第三临床学院骨科,安徽合肥230022

出　　处：《实用骨科杂志》2019年第2期109-112,共4页Journal of Practical Orthopaedics

基　　金：合肥市卫生计生委应用医学研究项目(hwk2017zd004)

摘　　要：目的观察关节镜辅助治疗急性后内侧角损伤的临床疗效。方法 2017年4月至2018年3月因外伤行膝关节镜手术的12例急性膝关节后内侧角损伤患者,其中男性7例,女性5例;年龄22～71岁,平均46.8岁。入选患者术前MRI均提示内侧副韧带损伤;体检膝关节0°位和屈曲30°外翻位应力试验均为阳性;术中进行关节镜下探查确认膝关节后内侧角损伤。12例均行内侧半月板后角成形术或者缝合术、内侧副韧带及后内侧角锚钉修补术。术后第6个月采用膝关节功能评分[Lysholm评分、西安大略和麦克马斯特大学骨关节炎指数评分(the western Ontario andMcMaster universities osteoarthritis index,WOMAC)]及视觉模拟评分(visual analogue scale,VAS),测量膝关节屈曲角度,评估膝关节功能。结果膝关节屈伸活动良好,未出现关节周围红肿及不稳定等症状。术前WOMAC评分(22.52±19.99)分,术后为(8.13±7.22)分,两组比较差异有统计学意义(P<0.05)。术前Lysholm评分(33.81±5.45)分,术后为(81.83±4.08)分,两组比较差异有统计学意义(P<0.05)。术前VAS疼痛评分(4.1±0.5)分,术后为(2.3±0.2)分,两组比较差异有统计学意义(P<0.05)。术前屈曲角度(85.95±8.80)°,术后为(115.73±6.71)°,两组比较差异有统计学意义(P<0.05)。结论结合关节镜下处理内侧半月板损伤,同时辅助切开修补后内侧角,具有安全、固定稳定等优点,膝关节功能恢复良好。Objective To observe the clinical effect of arthroscopic assisted treatment of acute posterior medial angle injury.Methods From April 2017 to March 2018,12 patients with acute posterior medial corner injury of knee joint were treated with knee arthroscopy due to trauma,among which 7 were males and 5 were females,aged 22~71 years old,with an average of 46.8 years old.Preoperative MRI showed the injury of medial collateral ligament.Physical examination knee flexion during and 30°﹑0° valgus stress test were all positive.Intraoperative arthroscopic exploration was performed to identify the posterior medial corner of the knee.All 12 cases were treated by medial meniscus posterior keratoplasty or suture,medial collateral ligament and posterior medial Angle anchoring.The knee function score (Lysholm and WOMAC) and VAS pain score were used to measure the knee flexion angle and evaluate the knee function at the 6th month after surgery.Results Knee flexion and extension activities were good,and there were no symptoms of periarticular redness and instability.Preoperative WOMAC score (22.52±19.99) and postoperative score (8.13±7.22) showed statistically significant differences between the two groups (P<0.05).Preoperative Lysholm score (33.81±5.45) and postoperative score (81.83±4.08) were significantly different between the two groups (P<0.05),VAS pain score (4.1±0.5) and postoperative score (2.3±0.2).Preoperative flexion angle (85.95±8.80)°,and postoperative flexion angle (115.73±6.71)° were statistically difference (P<0.05).Conclusion The injury of medial meniscus can be treated under arthroscopy,and assisted incision and repair of the posterior medial angle.which has the advantages of safety,stability and stability,and the well restored function of the knee joint.

关 键 词：关节镜 膝关节 后内侧角 外科手术 

分 类 号：R684[医药卫生—骨科学]