经胫骨隧道悬吊固定治疗半月板后根部撕脱损伤  

Clinical outcomes of meniscus posterior root horn repair using trans-tibial pull-out suspensory technique

作　　者：彭晨健 袁滨[2] 束昊[2] 黄瑶 孙鲁宁[2] Peng Chenjian;Yuan bin;Shu Hao;Huang Yao;Sun Luning(Departmentof Orthopedics, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210000,China;Department of Sports Medicine Center, Jiangsu Province of TCM,Nanjing 210000,China)

机构地区：[1]南京中医药大学附属南京中医院骨伤科,210000 [2]江苏省中医院运动医学中心,南京210000

出　　处：《中华关节外科杂志（电子版）》2020年第3期296-302,共7页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的观察关节镜下经胫骨隧道拉出悬吊固定技术治疗半月板后根部撕脱损伤的临床效果。方法自2014年9月至2017年12月,对20例前交叉韧带损伤伴随半月板后根部撕脱损伤的患者,在前交叉韧带单束重建的同时采用关节镜下经胫骨隧道拉出悬吊固定技术修复半月板后根部撕脱损伤。纳入前交叉韧带损伤伴随半月板后根部撕脱损伤的患者,排除术前下肢力线异常者及合并软骨损伤者。术前和术后1年时通过Lysholm评分和Tegner评分对患者膝关节功能进行评估,并通过磁共振(MR)观察术后半月板后根部撕脱损伤愈合情况。定量资料比较采用配对样本t检验。结果所有患者均进行超过1年的随访,患者术后1年随访时Lysholm评分及Tegner评分较术前均有显著提高(t=7.98、5.55,均为P<0.05);且MR观察未发现半月板后根部再撕裂或半月板体部外凸。结论关节镜下经胫骨隧道拉出悬吊固定技术可将半月板后根部撕脱复位并稳定固定于其解剖止点区域,从而维持半月板的环状结构以期最大程度恢复膝关节的功能,短期临床效果良好。Objective To evaluate the clinical outcome of arthroscopic trans-tibia pull-out suepensory technique in the treatment of meniscus posterior horn root tear.Methods From September 2014 to December 2017,twenty patients with both anterior cruciate ligament injury and meniscus posterior horn root tear were treated with single bundle anterior cruciate ligament reconstruction and a trans-tibial pull-out suspensory meniscal repair technique.The cases combined with cartilage injury and abnormal mechanical line of lower limb were excluded.The knee function was evaluated by Lysholm score and Tegner score before operation and one year after operation,the healing of meniscus posterior horn root was observed by magnetic resonance(MR).Paired-t test was used for comparing quantitative data.Results All the patients had a more than one year follow-up.The Lysholm score and Tegner score of patients one year after operation are significantly higher than those before operation(t=7.98,5.55 respectively,P<0.05),and MR showed no evidence of meniscal retear and extrusion.Conclusion Trans-tibial pull-out suspensory technique can anatomically fix the posterior horn root avulsion of meniscus,it can also restore the hoop of the meniscus,significantly improved the knee function,and achieve good short-term clinical outcome.

关 键 词：损伤 半月板 关节镜检查 膝关节 

分 类 号：R68[医药卫生—骨科学]