膝关节镜下腰穿套管针辅助钢丝引导缝合治疗外侧盘状半月板损伤  

Knee arthroscopic lumber trocar assisted and wire-guided suture for the treatment of lateral discoid meniscus injury

作　　者：代朋乙 王战朝 张智敏 赵晓非 Dai Pengyi;Wang Zhanchao;Zhang Zhimin;Zhao Xiaofei(Department of Knee Injury,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,河南洛阳471002

出　　处：《中国医刊》2021年第11期1219-1222,共4页Chinese Journal of Medicine

摘　　要：目的探讨膝关节镜下腰穿套管针辅助钢丝引导缝合治疗外侧盘状半月板损伤的临床效果。方法选取2014年8月至2018年8月河南省洛阳正骨医院膝部损伤科收治的31例(31膝)有症状的外侧盘状半月板损伤患者,均通过查体、膝关节MRI和关节镜检查确诊。膝关节镜下行盘状半月板成形术,然后在腰穿套管针辅助钢丝引导下缝合半月板撕裂部。分别于术前及术后6个月采用Lysholm膝关节功能评分、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)膝关节功能主观评价表评分和疼痛视觉模拟量表(visual analogue scale,VAS)评分评估膝关节功能情况,术前及术后1、3、6个月采用MRI检查评价损伤半月板的愈合情况。结果所有患者手术顺利,手术时间30~52min,平均(45.0±3.8)min;术后均获随访,随访时间13~25个月,平均(16.5±2.3)个月。术后所有患者完全清醒后即感术前症状消失,术后2周切口均甲级愈合并拆除缝线。术后MRI检查显示半月板撕裂部均已愈合,愈合时间为4~12周,平均(7.5±1.4)周。术后6个月Lysholm膝关节功能评分、IKDC膝关节功能主观评价表评分及VAS评分均明显优于术前,差异有显著性(P<0.05)。末次随访时所有患者均无术前症状,无切口感染、半月板再撕裂和血管神经损伤等并发症。结论膝关节镜下腰穿套管针辅助钢丝引导缝合治疗外侧盘状半月板损伤操作简便,可有效恢复外侧半月板的正常形态,稳定关节,术后膝关节功能恢复较好,短期效果满意,值得临床应用。Objective To investigate the clinical effect of knee arthroscopic lumber trocar assisted and wire-guided suture for the treatment of lateral discoid meniscus injury.Method From Aug 2014 to Aug 2018,31 patients(31 knees)with symptomatic lateral discoid meniscus injuries were diagnosed by physical examination,MRI and knee arthroscopy in Luoyang Orthopedic-Traumatological Hospital.In all patients,discoid menisci formation were performed under knee arthroscopy and menisci tear were then sutured with lumber trocar assisted and wire-guided.The Lysholm knee function score,the IKDC subjective function score of knee joint and VAS pain score were used to evaluate the clinical efficacy after the surgery.Meniscus healing was examined by MRI.Result All operations were well,and the operation time was 30-52min,with an average of(45.0±3.8)min.All patients were followed up for 13 to 25 months,with an average of(16.5±2.3)months.After the operation,the preoperative symptoms of all patients had disappeared,when they were completely awake.On the second weekend,all the incisions healed in grade A and the sutures were removed.All patients were followed up at the 1st,3rd,6th month and the last time after surgery to review knee function.MRI examination of the affected knees were performed at the 1st,3rd and 6th months after surgery,and meniscus laceration had healed with healing time ranging from 4 to 12 weeks,with an average of(7.5±1.4)weeks,and daily life had been resumed.The Lysholm scores,IKDC scores and VAS scores of all patients were significantly improved at the 6th month after surgery compared with those before surgery,and there were significant difference(t=3.723,P=0.001;t=3.550,P=0.001;t=30.311,P=0.000).Sports activities is available after the 6th month.At the last follow-up time,the preoperative symptoms of all patients disappeared,and the incision healed without any complications such as infection,retearing and neurovascular injury.Conclusion Knee arthroscopic lumber trocar assisted and wire-guided suture for the treatment

关 键 词：盘状半月板损伤 腰穿套管针 钢丝 膝关节镜 

分 类 号：R684.7[医药卫生—骨科学]