摘要
目的探讨关节镜下止点重建治疗膝关节外侧半月板后根部撕裂的临床效果。方法 2010年3月至2014年3月,18例膝关节外侧半月板后根部损伤患者接受关节镜手术治疗。其中单纯后根部损伤7例,后根联合体部放射状撕裂11例,18例中15例合并前交叉韧带（anterior cruciate ligament,ACL）损伤、3例合并多发韧带损伤者均一期重建。患者术前、术后进行膝关节主观功能评分测定,包括Lysholm评分、IKDC评分、（visual analog scale,VAS）疼痛评分。对随访患者进行MRI检查及二次关节镜探查了解外侧半月板损伤愈合情况。结果 18例随访6-41个月,平均20.2个月。患者术后膝关节Lysholm评分为90.0±4.5、IKDC评分为84.6±3.2、VAS疼痛评分为0.7±0.9,与术前比较,差异有统计学意义（P〈0.001）。18例于术后1年接受MRI检查,17例显示完全愈合,愈合率为94.4%。18例接受二次关节镜检查,外侧半月板损伤完全愈合,愈合率为100%。结论通过关节镜下止点重建治疗膝关节外侧半月板后根部撕裂的观察,更有利于对该区域的半月板损伤进行全内修复缝合,患者术后早期膝关节功能评分满意。
Objective To evaluate clinical outcomes of arthroscopic ending reconstruction of posterior root tear of the lateral meniscus in the knee. Methods From March 2010 to March 2014, 18 cases of posterior root tear of the lateral meniscus in the knee underwent arthroscopic ending reconstruction. Seven cases were of simple tear of the root, 11 were of combined radial tear of the posterior lateral complex. Fifteen cases combined with anterior cruciate ligament（ ACL） injury and 3 cases with multiple ligaments injury underwent one-stage reconstruction. Lysholm score, IKDC score and visual analog scale（ VAS） were applied to evaluate knee functions preoperatively and postoperatively. MRI and arthroscopic exploration of patients with follow-up were used to evaluate the healing of the lateral meniscus tear. Results The mean follow-up period was 20.2 months（ range： 6-41 months）. Postoperatively, the Lysholm knee score was 90.0±4.5, IKDC knee score was 84.6±3.2, VAS knee score was 0.7±0.9. Differences were statistically significant（ P0.001）. Eighteen cases received MRI examination 1 year postoperatively： 17 cases（ healing rate： 94.4%） showed completely healing of the meniscus and 18 cases（ healing rate： 100%） with cruciate ligaments injury were confirmed completely healing of the lateral meniscus by arthroscopic exploration. Conclusions Arthroscopic ending reconstruction is a good option in the treatment of posterior root tears of the lateral meniscus in the knee with the advantage of complete internal suture and reconstruction. It can receive satisfactory knee functions.
出处
《中国骨与关节杂志》
CAS
2015年第11期865-869,共5页
Chinese Journal of Bone and Joint
关键词
关节镜
半月板
前交叉韧带重建
膝关节
创伤和损伤
Arthroscope
Meniscus tibial injury
Anterior cruciate ligament reconstruction
Knee joint
Wounds and injuries
