膝关节半月板损伤的关节镜微创治疗

Minimally invasive treatment of meniscus injuries of the knee under arthroscope

目的探讨膝关节半月板损伤在关节镜下治疗的方法以及疗效。方法对165例膝关节半月板损伤患者应用膝关节镜诊治进行回顾性分析本组施行半月板部分切除成形术127例(其中包括部分切除及囊肿切除3例,盘状半月板部分切除成形术12例),大部分切除13例,全切除2例,表面修整10例,修补13例;同时行镜下前交叉韧带重建术47例,后交叉韧带重建7例,前、后交叉韧带同时重建2例,内侧皱襞切除术15例。结果137例患者后术后复查,追踪时间2～32个月,81例平均Lysholm-Ⅱ评分为92分(前、后交叉韧带重建术56例不参与评分),较术前提高49分。结论应用关节镜进行治疗半月板损伤可达到最大限度保留半月板,创伤小、恢复快、疗效佳,并可同时处理其他病变,诊断准确性高,避免漏诊。

Objective To investigate the therapeutic efficacy of meniscus injuries under arthroscope. Methods From 165 cases with meniscus injuries received operative treatment under arthroscope were analyzed retrospectively. Partial meniscectomy was performed in 127 cass, including 3 casea cystectomy plus partial meniscectomy and 12 cases partial meniscectomy for discoid meniscus. Subtotal meniscectomy was performed in 13 cases. Total meniscectomy was performed in 2 cases. Meniscus repair was performed in 13 cases. Surface trim was performed. Partial meniscectomy plus anterior cruciate ligament reconstruction were performed in 47 cases, partial meniscectomy plus posterior cruciate ligament reconstruction in 7 cases, partial meniscectomy plus anterior and posterior cruciate ligament reconstruction in 2 cases. Medial plica resection were was performed in 15 cases. Results 137cases were followed up for 2 to 32 months. According to lysholm U scow,the average score of knee function was 92 scoe in the 81 cases. Conclusion In the use of orthroscope to treat meniscus injury, it has many advantages, sluch as retaining meniscus in most degree, less trauma and a good ther peutic efficacy. At the same time, it can manage the other pathologic change and avoidmissed diagnosis.