关节镜下前交叉韧带重建并同期半月板由内向外缝合技术在半月板桶柄样撕裂中的应用  

Efficacy of arthroscopic reconstruction of anterior cruciate ligament and simultaneous meniscus inside-out suture in the treatment of meniscus bucket handle tear

作　　者：李想 常文举 王金子 孙振越 丁海 LI Xiang;CHANG Wenjyu;WANG Jinzi;SUN Zhenyue;DING Hai(Department of Orthopedics,the First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医科大学第一附属医院骨科,安徽蚌埠233004

出　　处：《中华全科医学》2024年第9期1508-1511,1525,共5页Chinese Journal of General Practice

基　　金：安徽省教育厅重点项目(KJ2020A0579)。

摘　　要：目的分析半月板由内向外缝合技术在半月板桶柄样撕裂关节镜下前交叉韧带重建患者中应用效果,并与全内缝合技术比较,以促进患者术后迅速恢复,保护关节功能。方法回顾性分析2018年5月—2023年5月蚌埠医科大学第一附属医院收治的120例交叉韧带断裂合并内侧半月板桶柄样撕裂患者资料,患者均接受关节镜下前交叉韧带重建,依据同期半月板缝合方式将全内缝合与由内向外缝合技术患者纳入全内缝合组(51例)与内-外缝合组(69例)。比较2组患者半月板愈合率,手术时间、住院时间与手术治疗费用,手术前后三维步态参数,并发症发生率。结果2组半月板愈合率(90.20%vs.94.20%,P>0.05)及手术时间、住院时间与手术治疗费用比较差异均无统计学意义;2组术后前-后位移、上-下位移、内-外位移、内-外翻以及内-外旋均下降,而屈直-伸直均上升(P<0.05),全内缝合组与内-外缝合组患者术后三维步态参数比较差异无统计学意义(P>0.05);2组患者关节间隙压痛及关节积液并发症发生率比较差异均无统计学意义(P>0.05),内-外缝合组膝内下区麻木发生率高于全内缝合组患者(13.04%vs.0,P<0.05)。结论关节镜下前交叉韧带重建并同期半月板缝合采用由内向外缝合技术的疗效与全内缝合法相当,但是其术后膝内下区麻木发生率相对较高。ObjectiveTo analyze the application effect of inside-out meniscus suture in the arthroscopic reconstruction of anterior cruciate ligament in patients with meniscus bucket handle tear and compare with total internal suture in order to promote rapid postoperative recovery and protect joint function.MethodsThe data of 120 patients with cruciate ligament rupture combined with barrel handle tear of medial meniscus treated in the First Affiliated Hospital of Bengbu Medical University from May 2018 to May 2023 were retrospectively analyzed.All patients underwent anterior cruciate ligament reconstruction under arthroscopy.Patients with total internal suture and inside-out suture were included in total internal suture group(n=51)and inside-out suture group(n=69)according to the simultaneous meniscus suture method.Meniscus healing rate,operation time,hospital stay and surgical treatment cost,three-dimensional gait parameters before and after operation,and incidence of complications were compared between the two groups.ResultsThere was no statistically significance difference in meniscus healing rate(90.20%vs.94.20%,P>0.05),operation time,hospital stay and surgical treatment cost between the two groups.The pre-post displacement,up-down displacement,inside-out displacement,inside eversion displacement,inside-out inversion and inside-out rotation decreased in both groups,while the flexus-extension increased(P<0.05).There was no statistically significant difference in the three-dimensional gait parameters between the two groups(P>0.05).There was no statistically significance difference in the incidence of joint space tenderness and joint effusion between the two groups(P>0.05).The incidence of numbness in the lower knee area in the internal external suture group was higher than that in the total internal suture group(13.04%vs.0,P<0.05).ConclusionArthroscopic anterior cruciate ligament reconstruction combined with simultaneous meniscus suture from the inside out has the same efficacy as total internal suture,but the incidence o

关 键 词：半月板桶柄样撕裂 前交叉韧带重建 半月板缝合技术 由内向外缝合 全内缝合 

分 类 号：R686.5[医药卫生—骨科学]