关节镜下两种松解技术治疗内侧半月板后角撕裂手术中的疗效对比研究  

Comparative study on the efficacy of two different medial collateral ligament by arthroscopy in the treatment of medial meniscus posterior horn tear

作　　者：姜于志 张崛[1] 高想 桂鉴超 JIANG Yu-zhi;ZHANG Jue;GAO Xiang(Department of Orthopedics,Nanjing Jiangning Hospital,Nanjing Medical University,Nanjing Jiangsu 211100,China)

机构地区：[1]南京医科大学附属江宁医院骨科,江苏南京211100 [2]南京医科大学附属南京医院骨科,江苏南京210001

出　　处：《临床和实验医学杂志》2022年第4期412-415,共4页Journal of Clinical and Experimental Medicine

基　　金：南京市医学科技发展重点项目(编号:ZKX17028)。

摘　　要：目的对比关节镜下行由外向内和由内向外内侧副韧带(MCL)松解术治疗内侧半月板后角撕裂(PHMMT)的临床疗效。方法回顾性将2018年3月至2020年5月南京医科大学附属江宁医院收治的62例MMT患者纳入本研究。根据治疗方式不同分成治疗A组和治疗B组,治疗A组患者采取关节镜下行由外向内MCL松解术治疗(n=28),治疗B组患者采取关节镜下行由内向外MCL松解技术治疗(n=34),术后随访12~18个月。比较两组围术期相关指标,松解前、松解后及术后4周的外翻应力试验结果,术前及术后1年的视觉模拟量表(VAS)评分、Lysholm评分和国际膝关节文献委员会膝关节评估表(IKDC)功能评分,术后1年半月板愈合和软骨退变情况。结果62例患者全部手术成功。治疗A组手术总耗时和松解时间为(48.72±4.24)、(1.05±0.24)min,明显少于治疗B组[(57.36±5.01)、(3.30±0.95)min],但治疗A组术后局部持续疼痛时间为(4.10±0.30)d,明显长于治疗B组[(2.80±0.20)d],差异均有统计学意义(P<0.05)。治疗A组中MCL松解术相关并发症发生率为28.6%,显著高于治疗B组的5.9%,差异无统计学意义(P<0.05)。两组术后4周的0°外翻应力试验结果差异无统计学意义(P>0.05)。两组术后1年的VAS评分、Lysholm评分、IKDC功能评分比较[(1.35±0.60)分vs.(1.48±0.71)分、(80.56±3.77)分vs.(82.36±3.84)分、(91.08±4.15)分vs.(93.07±4.23)分],差异无统计学意义(P>0.05)。两组术后1年的半月板愈合和内侧室相关软骨退变情况差异无统计学意义(P>0.05)。结论关节镜下经由两种不同方向行MCL松解术治疗PHMMT的疗效相当。Objective To compare the clinical efficacy of two different kinds of medial collateral ligament release(MCL)by arthroscopic in the treatment of medial meniscus posterior horn tear(MMPHT).Methods A total of 62 patients with MMPHT admitted to Jiangning Hospital affiliated to Nanjing Medical University from March 2018 to May 2020 were included in this retrospective study.According to the different treatment methods,the patients were divided into treatment group A and teatment group B.Patients in treatment group A were treated with arthroscopic release technique from outside to inside(n=28),and patients in treatment group B were treated with arthroscopic release technique from inside to outside(n=34).Postoperative follow-up time were 12 to 18 months.The peri-operative related indexes,valgus stress test results before release,after release and 4 weeks after operation,visual analog scale(VAS)score,Lysholm score and the international knee documentation committee knee evaluation form(IKDC)function score before and 1 year after operation,meniscus healing and cartilage degeneration 1 year after operation were compared between the two groups.Results 62 patients were operated successfully.The total operation time and release time in treatment group A were(48.72±4.24)and(1.05±0.24)min,which were significantly less than those in treatment group B[(57.36±5.01)and(3.30±0.95)min],the postoperative local persistent pain time was(4.10±0.30)d,which was significantly longer than that in treatment group B[(2.80±0.20)d],and the differences were statistically significant(P<0.05).The incidence of complications of treatment group A was 28.6%,which was significantly higher than that in group B(5.9%),the difference was statistically significant(P<0.05).There was no significant difference in the results of 0°valgus stress test 4 weeks after operation between the two groups(P>0.05).One year after operation,there was no significant difference in the scores of VAS,Lysholm,IKDC function scores between the two groups[(1.35±0.60)points vs.

关 键 词：关节镜 内侧半月板后角撕裂 内侧副韧带松解术 疗效 

分 类 号：R687.4[医药卫生—骨科学]