手术重建半月板联合仙灵骨葆胶囊治疗内侧半月板后根撕裂的效果  

The Effect of Surgical Reconstruction of Meniscus Combined with Xianling Gubao Capsule in the Treatment of Medial Meniscus Posterior Root Tear

作　　者：兰敏 聂思 廖新根[1] 李洪波[1] LAN Min;NIE Si;LIAO Xin-gen;LI Hong-bo(Department of Orthopedic Surgery,Jiangxi Provincial People’s Hospital/the First Affiliated Hospital of Nanchang Medical College,Nanchang 330006,China;Department of Medical Imaging,Jiangxi Provincial People’s Hospital/the First Affiliated Hospital of Nanchang Medical College,Nanchang 330006,China)

机构地区：[1]江西省人民医院、南昌医学院第一附属医院骨科,南昌330006 [2]江西省人民医院、南昌医学院第一附属医院影像科,南昌330006

出　　处：《实用临床医学（江西）》2024年第5期37-42,F0004,共7页Practical Clinical Medicine

基　　金：江西省卫健委中医药科研课题(2020B467)。

摘　　要：目的比较内侧半月板后根撕裂(MMPRT)患者行不同后根重建技术联合仙灵骨葆胶囊治疗的临床和影像学结果。方法回顾性分析155例MMPRT患者,按治疗方法的不同分为1、2、3、4和5组,其中1组(异体肌腱生物重建内侧半月板后根,联合口服仙灵骨葆胶囊)33例,2组(异体肌腱生物重建内侧半月板后根)33例,3组(“pull-out”技术重建内侧半月板后根,联合口服仙灵骨葆胶囊)29例,4组(“pull-out”技术重建内侧半月板后根)29例,5组(单纯口服仙灵骨葆胶囊)31例。所有患者均随访>2年。口服比较各组患者治疗前和末次随访时膝关节视觉模拟评分表(VAS)评分、Lysholm评分和国际膝关节文献委员会(IKDC)评分、膝骨关节炎Kellgren-Lawrence(K-L)分级和半月板外突距离,以及末次随访时半月板后根愈合状态。结果末次随访时:各组患者膝关节VAS评分均低于治疗前,1、2、3和4组患者Lysholm和IKDC评分均高于治疗前(均P<0.05),1组患者VAS、Lysholm和IKDC评分均较其他组患者明显改善(均P<0.05);2、3、4和5组患者K-L分级大于治疗前(均P<0.05),1组患者K-L分级优于其他组患者(均P<0.05);各组患者半月板外突距离均小于治疗前(均P<0.05),1组患者半月板外突距离小于其他组患者(均P<0.05);1组患者半月板后根完全愈合率高于3、4和5组患者(均P<0.05)。结论MMPRT进行手术重建半月板后根,可明显改善术后短期临床和影像学结果,联合仙灵骨葆胶囊可增强疗效。对比其他治疗方式,肌腱加强固定MMPRT联合口服仙灵骨葆胶囊可显著抑制膝关节退变和半月板外突的进展。Objective To compare the clinical and radiological outcomes of different posterior root reconstruction techniques combined with Xianling Gubao capsules in patients with medial meniscus posterior root tear(MMPRT).Methods A retrospective analysis was conducted on 104 patients with MMPRT,who were divided into groups 1,2,3,4,and 5 based on different treatment methods.Specifically,Group 1(n=33)underwent allogeneic tendon biological reconstruction of the posterior root of the medial meniscus combined with oral administration of Xianling Gubao capsules;Group 2(n=33)received allogeneic tendon biological reconstruction of the posterior root of the medial meniscus without the capsules;Group 3(n=29)underwent“pull-out”technique for posterior root reconstruction of the medial meniscus combined with oral administration of Xianling Gubao capsules;Group 4(n=29)received“pull-out”technique for posterior root reconstruction of the medial meniscus without the capsules;and group 5(n=31)received only oral administration of Xianling Gubao capsules.All patients were followed up for more than 2 years.The visual analog scale(VAS)scores,Lysholm scores,and International Knee Documentation Committee(IKDC)scores,Kellgren-Lawrence(K-L)grading for knee osteoarthritis,and the distance of meniscal extrusion were compared among the groups before treatment and at the final follow-up;the healing status of the posterior root of the meniscus was evaluated at the final follow-up.Results At the final follow-up,the VAS scores for knee joints in all groups were lower than those before treatment;the Lysholm and IKDC scores in Groups 1,2,3,and 4 were higher than those before treatment(all P<0.05);the VAS,Lysholm,and IKDC scores in Group 1 were significantly improved compared to the other groups(all P<0.05).At the final follow-up,the K-L grading in groups 2,3,4,and 5 were higher than before treatment(all P<0.05);the K-L grading in Group 1 was better than that in the other groups(all P<0.05).At the final follow-up,the distance of meniscal extrusion in

关 键 词：内侧半月板后根撕裂 肌腱移植 关节镜辅助重建技术 仙灵骨葆胶囊 膝关节功能 半月板外突 

分 类 号：R684[医药卫生—骨科学]