经胫骨骨隧道技术修复膝关节外侧半月板体部完全放射状撕裂的近期疗效  

Short-term effectiveness of transtibial pull-out technique for complete radial tear of lateral meniscus body

作　　者：仲鹤鹤 孙鹏鹏 陈菁 姚浩浩 熊华章 吴术红 ZHONG Hehe;SUN Pengpeng;CHEN Jing;YAO Haohao;XIONG Huazhang;WU Shuhong(Department of Orthopedics,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou,563000,P.R.China)

机构地区：[1]遵义医科大学附属医院骨科,贵州遵义563000

出　　处：《中国修复重建外科杂志》2025年第4期446-450,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 探讨经胫骨骨隧道技术联合边对边缝合技术治疗膝关节外侧半月板体部完全放射状撕裂的近期疗效。方法 2020年5月—2023年8月,对15例膝关节外侧半月板体部完全放射状撕裂患者,采用关节镜下经胫骨骨隧道技术联合边对边缝合技术进行治疗。男11例,女4例;年龄15~43岁,平均25.2岁。急性损伤12例,陈旧性损伤3例。患者膝关节外侧间隙均有压痛,膝关节正侧位X线片未见力线异常,MRI检查示外侧半月板体部放射状撕裂,无前交叉韧带及软骨等其他合并损伤。术前Lysholm评分、国际膝关节文献委员会(IKDC)主观评分、Tegner评分、疼痛视觉模拟评分(VAS)分别为(44.5±6.4)、(40.2±8.4)、(1.3±1.1)、(5.1±1.1)分。记录手术时间、切口愈合情况及合并血管、神经损伤等情况。随访时观察膝关节屈伸活动度及膝关节外侧间隙压痛情况,采用Lysholm评分、Tegner评分、IKDC主观评分和VAS评分评价膝关节功能及疼痛情况,影像学复查评估膝关节退变情况。结果 手术时间60~145 min,平均89.6 min。术后切口均Ⅰ期愈合,未发生血管、神经损伤等并发症。15例均获随访,随访时间17~56个月,平均38.4个月。所有患者无伸膝受限,膝关节外侧间隙压痛3例。末次随访膝关节Lysholm评分、IKDC主观评分、Tegner评分及VAS评分分别为(85.3±7.8)、(82.1±15.7)、(4.7±1.2)及(1.5±1.0)分,均较术前改善(P<0.05)。影像学复查示,术后1 d半月板复位,末次随访时未见膝关节退变表现。结论 经胫骨骨隧道技术联合对边缝合技术治疗外侧半月板体部完全放射状撕裂,可获得良好近期疗效。Objective To investigate the short-term effectiveness of transtibial pull-out technique combined with side-to-side suture technique in treatment of complete radial tear of lateral meniscus body.Methods Between May 2020 and August 2023,15 patients with complete radial tear of lateral meniscus body were repaired by arthroscopic transtibial pull-out technique combined with side-to-side suture technique.There were 11 males and 4 females,with an average age of 25.2 years(range,15-43 years).Twelve cases were acute injuries and 3 were chronic injuries.All patients had tenderness in the lateral compartment of the knee.No abnormal alignment was observed on the X-ray films of the knee.MRI showed the complete radial tear of lateral meniscus body without associated injuries such as anterior cruciate ligament or cartilage.Preoperative Lysholm score was 44.5±6.4,International Knee Documentation Committee(IKDC)subjective score was 40.2±8.4,Tegner score was 1.3±1.1,and visual analogue scale(VAS)score for pain was 5.1±1.1.The operation time,incision healing,and complications such as vascular/nerve injury were recorded.During follow-up,the range of motion of the knee and tenderness in the lateral compartment of the knee were observed.The knee function and pain were evaluated using Lysholm score,Tegner score,IKDC subjective score,and VAS score.X-ray films and MRI of the knee were reexamined to assess knee degeneration.Results The operation time was 60-145 minutes(mean,89.6 minutes).All incisions healed by first intention,and no complication such as vascular/nerve injury occurred.All patients were followed up 17-56 months (mean, 38.4 months). All patients had no knee extension limitation and 3 cases had tenderness in thelateral compartment of the knee. At last follow-up, the Lysholm score, IKDC subjective score, Tegner score, and VASscore for pain were 85.3±7.8, 82.1±15.7, 4.7±1.2, and 1.5±1.0, respectively, which were superior to those before operation(P<0.05). Imaging reexamination showed that the meniscus was reset at 1 d

关 键 词：膝关节 外侧半月板 放射状撕裂 关节镜 经胫骨骨隧道技术 对边缝合技术 

分 类 号：R687.4[医药卫生—骨科学]