关节镜下半月板部分切除术与半月板成形术治疗中青年膝关节半月板损伤患者的疗效对比  

Effects of arthroscopic partial meniscectomy and arthroscopic meniscus plasty for knee meniscus injury in young and middle-aged patients:a comparative study

作　　者：张昆阳 毕方刚[2] 王向鹏 ZHANG Kunyang;BI Fanggang;WANG Xiangpeng(Department of Orthopaedics,the Ninth People's Hospital of Zhengzhou,Zhengzhou,Henan 450003,China;不详)

机构地区：[1]郑州市第九人民医院骨科,450003 [2]郑州大学第一附属医院骨科,450052

出　　处：《中国骨科临床与基础研究杂志》2021年第3期92-96,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

基　　金：河南省高等学校重点科研项目计划(19A320011)。

摘　　要：目的对比研究关节镜下半月板部分切除术与半月板成形术治疗中青年膝关节半月板损伤的效果及对患者预后的影响。方法选取2018年2月至2020年1月收治的87例中青年膝关节半月板损伤患者,按治疗方案的不同分为A、B两组,分别施行关节镜下半月板部分切除术(45例)和半月板成形术(42例)。比较两组患者手术相关指标和术后6个月治疗总有效率,评估术前,术后4、6个月膝关节活动度、膝关节功能和疼痛程度,记录随访期间并发症发生情况。结果A组术后住院时间短于B组,差异具有统计学意义(P<0.05),两组手术时间、术中出血量比较无统计学差异(P>0.05);A组患者治疗总有效率、并发症发生率均高于B组,但差异无统计学意义(P>0.05);两组患者术后4、6个月膝关节活动度、膝关节功能Lysholm评分和疼痛数字评价量表(NRS)评分均较术前改善,A组改善程度优于B组,差异均有统计学意义(P<0.05)。结论关节镜下半月板部分切除术和半月板成形术治疗中青年膝关节半月板损伤患者均可获得良好的短期效果;与半月板成形术比较,半月板部分切除术术后康复时间更短,短期内可更好地改善患者膝关节活动度、膝关节功能及疼痛症状,临床上建议根据患者功能要求及半月板损伤情况选择手术方式。Objective To compare the effects and prognosis of arthroscopic partial meniscectomy and arthroscopic meniscus plasty for knee meniscus injury in young and middle-aged patients.Methods A total of 87 young and middle-aged patients with knee meniscus injury admitted from February 2018 to January 2020,were enrolled in the study.According to different surgical approaches,patients were divided into group A(n=45,treated with arthroscopic partial meniscectomy)and group B(n=42,treated with arthroscopic meniscus plasty).Operation related indexes of patients as well as total effective rate evaluated at 6 months postoperatively were compared between two groups.The knee range of motion(ROM),knee function and pain symptom of patients in two groups were evaluated before the surgery and at 4,6 months after the surgery.Incidence of complications was recorded during the follow-up.Results Postoperative hospital stay in group A was shorter than that of group B,the difference was statistically significant(P<0.05).There was no statistical difference of operation time or intraoperative estimate blood loss between two groups(P>0.05).Although the total effective rate and incidence of complications in group A were higher than those in group B,there were no statistical differences between two groups(P>0.05).The knee ROM,Lysholm scores as well as numerical rating scale(NRS)scores at 4,6 months postoperatively in two groups all improved when compared with preoperative ones(P<0.05).The improvement of the above scores in group A was better than that in group B(P<0.05).Conclusions Both of arthroscopic partial meniscectomy and arthroscopic meniscus plasty have good short-term curative effects in the treatment of young and middle-aged patients with meniscus injury.In the short-term,arthroscopic partial meniscectomy could further increase knee ROM,improve knee function and alleviate pain with shorter rehabilitation time when compared with arthroscopic menisus plasty,and clinically,the surgical approaches should be suggested to select according to

关 键 词：关节镜检查 膝关节 半月板损伤 半月板部分切除术 半月板成形术 中年人 青年人 

分 类 号：R684.76[医药卫生—骨科学] R687.4[医药卫生—外科学]