膝关节镜下半月板成形联合钢丝引导缝合治疗外侧盘状半月板损伤的临床疗效观察  

Knee arthroscopic meniscus formation and wire-guided suture for the treatment of lateral discoid meniscus injury

作　　者：代朋乙 张智敏 DAI Peng-yi;ZHANG Zhi-min(Knee Injury Department,Luoyang Orthopedic-Traumatological Hospital,Henan Orthopedic Hospital,Henan Luoyang 471002,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)膝部损伤科

出　　处：《中国医刊》2019年第7期735-738,共4页Chinese Journal of Medicine

摘　　要：目的 探讨膝关节镜下半月板成形联合钢丝引导缝合治疗外侧盘状半月板损伤的临床疗效。方法选择2014年7月至2018年1月河南省骨科医院收治的有症状的外侧盘状半月板损伤患者66例(67膝),经体格检查、MRI和膝关节镜确诊后,随机分为A组(33例,33膝)和B组(33例,34膝)。A组膝关节镜下保留损伤的半月板周缘5~6mm以成形,同时在钢丝引导下对半月板撕裂部位进行缝合固定;B组行膝关节镜下损伤的半月板部分切除成形术。术后采用Lysholm膝关节功能评分、视觉模拟评分法(visual analogue scale,VAS)评分及治疗有效率对两组的临床疗效进行评估。结果 两组患者均获随访,随访时间均为12~16个月,其中A组平均随访(13.3±1.6)个月,B组平均随访(12.5±1.2)个月。所有患者末次随访时术前症状均消失,切口甲级愈合,无再撕裂、切口感染、神经血管损伤等并发症。MRI检查示半月板撕裂部均已愈合,愈合时间8~12周,平均(9.6±1.6)周,均已恢复日常生活及运动。两组术前Lysholm评分、VAS评分比较差异无显著性(P>0.05);术后6个月两组Lysholm评分、VAS评分均较术前明显改善,差异有显著性(P<0.05),但两组间比较差异无显著性(P>0.05)。两组治疗有效率均为100%,差异无显著性(P>0.05)。结论 采用膝关节镜下半月板成形联合钢丝引导缝合治疗外侧盘状半月板损伤,可最大程度地保留半月板,并能同时行半月板撕裂部位缝合固定,保持了关节的稳定性,术后膝关节功能恢复好,短期疗效满意,值得临床推广应用。Objective To investigate the clinical effect of knee arthroscopic meniscus formation and wire-guided suture for the treatment of lateral discoid meniscus injury. Method From July 2014 to January 2018, 66 patients (67 knees) with symptomatic lateral discoid meniscus injuries diagnosed by physical examination,MRI and knee arthroscopy and treated were randomly divided into two groups. In group A, 5-6 mm periphery of the injured meniscuses were retained under knee arthroscopic meniscus for formation, and the torn meniscuses were stitched and fixed by the guidance of steel wire;In group B, the injured meniscuses were partially removed to form underwent knee arthroscopy. The Lysholm knee function score, VAS pain score and treatment efficiency were used to evaluate the clinical efficacy after the surgery. Result 33 cases (33 knees) in group A and 33 cases (34 knees) in group B were followed up for 12-16 months. The average follow-up time in group A was (13.3±1.6) months, while that in group B was (12.5±1.2) months. Preoperative symptoms disappeared in all patients, and the incisions healed in grade A. There were no complications such as re-tearing, incision infection, nerve and blood vessel injury. MR showed that meniscus tear healed, The healing time was 8-12 weeks with an average of (9.6±1.6) weeks. The meniscus tear resumed daily life and exercise. The Lysholm score and VAS pain score of the two groups at 6 months after operation were significantly different from those before operation (P<0.05), while there was no significant difference in Lysholm score and VAS pain score between the two groups before operation and 6 months after operation (P>0.05). The effective rates of both groups were 100%. There was no significant difference between the two groups (P>0.05). Conclusion Knee arthroscopic meniscus formation and wire-guided suture for the treatment of lateral discoid meniscus injury can preserve the meniscus to the greatest extent, stitch and fix the meniscus tear site at the same time, maintain stability, and re

关 键 词：盘状半月板损伤 半月板成形 钢丝引导缝合 膝关节镜 

分 类 号：R687.42[医药卫生—骨科学]