关节镜下经胫骨隧道带袢钢板固定与常规锚钉固定治疗内侧半月板后根部撕裂的比较研究  

A comparative study of arthroscopic Endobutton plate fixation through tibial tunnel versus conventional arthroscopic suture anchor fixation for treatment of medial meniscus posterior root tear

作　　者：张文桥 沈烈军 陈文锋 ZHANG Wenqiao;SHEN Liejun;CHEN Wenfeng(Zhoushan Dinghai Guanghua Hospital,Zhoushan 316000,Zhejiang,China)

机构地区：[1]舟山定海广华医院,浙江舟山316000

出　　处：《中医正骨》2021年第11期24-30,共7页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：舟山市卫生健康委员会医药卫生科技计划项目(2020YB05)。

摘　　要：目的:比较关节镜下经胫骨隧道带袢钢板固定与常规锚钉固定治疗内侧半月板后根部撕裂的临床疗效及安全性。方法:将106例内侧半月板后根部撕裂患者随机分为2组,每组53例,在关节镜辅助下分别采用经胫骨隧道带袢钢板固定(带袢钢板固定组)与常规锚钉固定(锚钉固定组)治疗。记录并比较2组患者的手术时间、术后下床时间、住院时间、膝关节主动屈伸范围、膝关节被动屈伸范围、膝关节文献委员会(International Knee Documentation Committee,IKDC)评分、Tegner膝关节活动水平评分、Lysholm膝关节评分及并发症发生情况。结果:①一般指标。2组患者的手术时间比较,差异无统计学意义[(110.52±18.64)min,(105.63±20.76)min,t=1.276,P=0.205];带袢钢板固定组患者的术后下床时间、住院时间均短于锚钉固定组[(24.35±6.87)h,(28.14±7.52)h,t=-2.709,P=0.008;(6.57±1.85)d,(7.76±1.94)d,t=-3.232,P=0.002]。②膝关节主动屈伸范围。术前2组患者膝关节主动屈伸范围比较,差异无统计学意义(45.92°±7.21°,44.52°±7.02°,t=1.013,P=0.313);术后1年,带袢钢板固定组患者的膝关节主动屈伸范围大于锚钉固定组(102.74°±10.64°,95.76°±9.56°,t=3.553,P=0.001),2组患者膝关节主动屈伸范围均较术前增大(t=33.564,P=0.000;t=27.790,P=0.000)。③膝关节被动屈伸范围。术前2组患者膝关节被动屈伸范围比较,差异无统计学意义(50.21°±6.85°,50.55°±6.88°,t=-0.255,P=0.799);术后1年,带袢钢板固定组患者的膝关节被动屈伸范围大于锚钉固定组(114.35°±11.58°,105.38°±10.25°,t=4.223,P=0.000),2组患者膝关节被动屈伸范围均较术前增大(t=36.116,P=0.000;t=32.268,P=0.000)。④IKDC评分。术前2组患者IKDC评分比较,差异无统计学意义[(31.58±4.29)分,(30.99±5.01)分,t=0.651,P=0.516];术后1年,带袢钢板固定组患者的IKDC评分高于锚钉固定组[(51.34±5.76)分,(45.76±7.52)分,t=4.289,P=0.000],2组患者IKDC评分均较Objective:To compare the clinical curative effects and safety of arthroscopic Endobutton plate(EP)fixation through tibial tunnel versus conventional arthroscopic suture anchors(SA)fixation for treatment of medial meniscus posterior root tear(MMPRT).Methods:One hundred and six MMPRT patients were enrolled in the study and were randomly divided into 2 groups, 53 cases in each group,and they were treated with arthroscopic EP fixation through tibial tunnel( EP fixation group) and conventional arthroscopic SA fixation( SA fixation group) respectively. The operative time,bed rest time,hospital stay,active knee flexion-extension range of motion( ROM),passive knee flexion-extension ROM,International Knee Documentation Committee( IKDC) score,knee Tegner Activity scale( TAS) score,Lysholm knee score( LKS) and complications were recorded and compared between the 2 groups. Results:(1)There was no statistical difference in operative time between the 2 groups( 110. 52 ± 18. 64 vs 105. 63 ± 20. 76 minutes,t = 1. 276,P = 0. 205). The bed rest time and hospital stay were shorter in EP fixation group compared to SA fixation group( 24. 35 ± 6. 87 vs 28. 14 ± 7. 52 hours,t =-2. 709,P =0. 008;6. 57 ± 1. 85 vs 7. 76 ± 1. 94 days,t =-3. 232,P = 0. 002).(2)There was no statistical difference in active knee flexion-extension ROM between the 2 groups before the surgery( 45. 92 ± 7. 21 vs 44. 52 ± 7. 02 degrees,t = 1. 013,P = 0. 313). The active knee flexion-extension ROM was greater in EP fixation group compared to SA fixation group at 12 months after the surgery( 102. 74 ± 10. 64 vs 95. 76 ±9. 56 degrees,t = 3. 553,P = 0. 001),and increased in the 2 groups at 12 months after the surgery compared to pre-surgery( t = 33. 564,P = 0. 000;t = 27. 790,P = 0. 000).(3)There was no statistical difference in passive knee flexion-extension ROM between the 2 groups before the surgery( 50. 21 ± 6. 85 vs 50. 55 ± 6. 88 degrees,t =-0. 255,P = 0. 799). The passive knee flexion-extension ROM was greater in EP fixation group compared to SA fix

关 键 词：膝损伤 半月板 关节镜检查 缝合锚 带袢钢板 胫骨隧道 临床试验 

分 类 号：R687.4[医药卫生—骨科学]