关节镜利用腘肌腱缝合固定外侧半月板腘肌腱区损伤  

Arthroscopic surgery for injuries to the popliteal tendon area of the lateral meniscus

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作  者:张明涛 杨智涛 刘涛[1] 张柏荣 谭小义[1,2] 姜金 安丽萍[1,2] 韵向东 ZHANG Ming-tao;YANG Zhi-tao;LIU Tao;ZHANG Bo-rong;TAN Xiao-yi;JIANG Jin;AN Li-ping;YUN Xiang-dong(Department of Orthopaedics,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China;The Key Laboratory of Bone and Joint Diseases Research of Gansu Provincial,Lanzhou 730030,Gansu,China)

机构地区:[1]兰州大学第二医院骨科,甘肃兰州730030 [2]甘肃省骨关节疾病研究重点实验室,甘肃兰州730030

出  处:《中国骨伤》2024年第7期713-717,共5页China Journal of Orthopaedics and Traumatology

基  金:国家自然科学基金地区项目(编号:82160422);甘肃省自然科学基金项目(编号:20JR10RA723)。

摘  要:目的:探讨关节镜下利用腘肌腱缝合固定外侧半月板腘肌腱区损伤的中期疗效及相关并发症。方法:回顾性分析2016年1月至2020年12月收治的经关节镜下腘肌腱缝合固定术治疗的57例外侧半月板腘肌腱区损伤患者资料,其中男35例,女22例,年龄18~47(32.9±7.9)岁。比较术前、末次随访时国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分、Lysholm评分评价膝关节功能,根据术后Barrett标准评估半月板愈合情况,并记录术后切口愈合情况,腘肌腱、血管、神经损伤及下肢静脉血栓等并发症情况。结果:57例患者术后均获得随访,时间12~58(38.1±14.9)个月。术后患者切口均为甲级愈合,无感染,无腘肌腱、血管、神经损伤及下肢静脉血栓情况。IKDC评分由术前的(49.7±3.6)分增至末次随访的(88.5±4.4)分(P<0.05);Lysholm评分由术前的(48.8±4.9)分增至末次随访的(91.9±3.9)分(P<0.05)。术后3、6个月及1年随访,根据Barrett评价标准,术后临床愈合54例,愈合率94.7%(54/57)。结论:本研究初步证实通过关节镜缝合技术将损伤的外侧腘肌腱区半月板缝合固定于腘肌腱可取得较好的临床稳定效果,且术后中期随访未见对膝关节功能造成不利影响。Objective To investigate the mid-term effect and complications of arthroscopic popliteal tendon suture in the treatment of lateral meniscus injury.Methods From January 2016 to December 2020,the data of 57 patients with lateral meniscus popliteal tendon injury treated by arthroscopic popliteal tendon suture fixation were retrospectively analyzed,including 35 males and 22 females,aged from 18 to 47 years old with an average of(32.9±7.9)years old.Knee function was evaluated using the International Knee Documentation Committee(IKDC)and Lysholm scores both before the operation and at the final follow-up.Meniscus healing was evaluated according to the postoperative Barrett standard.Wound healing complications,such as vascular injury,nerve injury,and lower extremity venous thrombosis,were recorded.Results All 57 patients were followed up for 12 to 58 months with an average of(38.1±14.9)months.The incisions of the patients after the operation were all Grade A healing without infection,popliteal tendon injury,blood vessel injury,nerve injury and lower extremity venous thrombosis.The IKDC score increased from(49.7±3.6)points preoperatively to(88.5±4.4)points in the final follow-up(P<0.05).The Lysholm score increased from(48.8±4.9)points preoperatively to(91.9±3.9)points at the final follow-up(P<0.05).At 3,6 months and 1 year after operation,according to Barrett's criteria,54 cases were clinically healed,the healing rate was 94.7%(54/57).Conclusion This study preliminarily confirmed that arthroscopic suture technique can result in clinical stability through suture and fixation of the meniscus in the injured lateral popliteal tendon area.No adverse effects on knee joint function were found in the mid-term follow-up after the operation.

关 键 词:膝关节 外侧半月板撕裂 腘肌腱 关节镜 

分 类 号:R684.7[医药卫生—骨科学]

 

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