关节镜下隧道拉线和缝合法在不同撕裂损伤类型外侧半月板后根损伤中的应用价值  

Application value of arthroscopic tunnel pulling and suturing in different types of lateral meniscus posterior root injuries

作　　者：倪建龙[1] 张宝庆 李强 李文高 Ni Jianlong;Zhang Baoqing;Li Qiang;Li Wengao(Department of Sports Medicine,Orthopedic Center,Second Afiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Orthopaedics,Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi'an 710082,China)

机构地区：[1]西安交通大学第二附属医院骨科中心运动医学科,西安710004 [2]陕西省中医医院骨伤一科,西安710082

出　　处：《国际外科学杂志》2025年第3期156-163,共8页International Journal of Surgery

基　　金：陕西省重点研发高校联合项目(2020GXLH-Y-011)。

摘　　要：目的:探究关节镜下隧道拉线和缝合法在WestⅡ型和WestⅢ型外侧半月板后根损伤中的应用价值。方法:采用回顾性对照研究的方法,分析2022年5月—2023年6月在西安交通大学第二附属医院接受手术治疗WestⅡ型和Ⅲ型外侧半月板后根损伤的各92例患者的病历资料,按随机数字表法将WestⅡ型和Ⅲ型患者均分为隧道法组和缝合法组,每组均46例。WestⅡ型隧道法组中男性23例,女性23例,年龄(48.36±2.52)岁;缝合法组中男性患者25例,女性21例,年龄(48.61±2.21)岁。WestⅢ型隧道法组男性24例,女性22例,年龄(48.53±2.36)岁;缝合法组男性24例、女性22例,年龄(46.38±2.67)岁。隧道法组采用关节镜下胫骨隧道拉线固定法,缝合法组采用关节镜下半月板全内缝合法。对比不同West分型患者隧道法组与缝合法组手术时间、住院时长、术后首次下床时间;通过Lysholm、Tegner、国际膝关节文献委员会膝关节评估表(IKDC)、视觉模拟评分(VAS)对比手术前后膝关节功能评分;采用MRI检查患者外侧半月板挤压情况;对比不良反应发生率。计量资料以均数±标准差(±s)表示,组间比较采用t检验,计数资料以例(百分比)[例(%)]表示,组间比较采用χ^(2)检验或Fisher确切概率法。偏态分布的计量资料以中位数(四分位间距)[M(Q1,Q3)]表示,组间比较采用秩和检验。结果:WestⅡ型、Ⅲ型隧道法组和缝合组患者手术时间、住院时长、术后首次下床时间两组相比差异无统计学意义(P>0.05)。术后12个月时,WestⅡ型患者隧道法组与缝合法组Lysholm评分、Tegner评分、IKDC评分及VAS评分相比较,差异均无统计学意义(P>0.05),而WestⅢ型隧道法组Lysholm评分和IKDC评分均显著高于缝合法组,差异均具有统计学意义(P<0.05),而Tegner评分和VAS评分,差异无统计学意义(P>0.05)。术后12个月时,不同West分型患者隧道法组与缝合法组半月板整体宽度比较差异均无统计�Objective:To explore the application value of arthroscopic tunnel pulling and suturing methods in West typeⅡandⅢlateral meniscus posterior root injuries.Methods:A total of 184 patients with WestⅡ(n=92)andⅢ(n=92)lateral meniscus posterior root injuries who underwent surgical treatment in Second Affiliated Hospital of Xi′an Jiaotong University from May 2022 to June 2023 were selected as the study subjects,by adopting a retrospective controlled study method.Using a random number table method,WestⅡandⅢpatients were divided into a tunnel method group and a suture method group,with 46 patients in each group.There were 23 male and 23 female patients in the WestⅡtunnel method group,with an age of(48.36±2.52)years.There were 25 male and 21 female patients in the suture method group,with an age of(48.61±2.21)years.There were 24 male and 22 female patients in the WestⅢtunnel method group,with an age of(48.53±2.36)years.There were 24 male and 22 female patients in the suture method group,with an age of(46.38±2.67)years.The tunnel method group used arthroscopic tibial tunnel cable fixation method,while the suture method group used arthroscopic full internal meniscus suture method.Compared the surgical time,length of hospital stay,and first postoperative time of getting out of bed between the tunnel method group and the suture method group of patients with different subtypes.Compared the knee joint function scores(Lysholm,Tegner,IKDC,VAS)before and after surgery.Used MRI to examine the compression of the patient′s lateral meniscus.Compared the incidence of adverse reactions.Measurement data with normal distribution were represented as mean±standard deviation(±s),and the comparison between groups was conducted using the t-test;the comparison of count data were represented as[n(%)]and was conducted by chi-square test or Fisher exact probability.The skewness data were expressed by M(Q1,Q3),and rank-sum test was used for inter-group comparison.Results:There was no significant difference in surgical time,l

关 键 词：半月板 关节镜 膝关节 缝合技术 

分 类 号：R687[医药卫生—骨科学]