54例关节镜下盘状软骨成形手术的中期随访

Midterm follow-up of symptomatic discoid meniscus after arthroscopic surgery

目的评价关节镜下盘状软骨成形术治疗症状性膝盘状软骨损伤的中期临床结果以及少儿与成人盘状软骨手术后的疗效差异。方法我们对1997年1月至2000年12月4年间施行关节镜手术治疗的243例(278膝)膝关节盘状软骨损伤的病例进行了回顾性研究。结果54例(57膝)接受盘状软骨成形的患者获得7年以上随访,其中少儿患者38例,成人患者16例。Lysholm评分:少儿组从术前平均(62.41±3.24)分提高到术后的(84.89±3.77)分;成年组术前(54.88±4.15)分,术后提高到(69.18±4.10)分。平均8.2年随访结果显示,少儿组无明显主观症状与客观体征以及膝关节骨关节炎改变,而成人组14膝出现关节退变的X线特征性改变,其中6膝伴有不同程度的骨关节炎症状与体征。结论以关节镜下盘状软骨成形术治疗症状性盘状软骨可有效改善关节症状与功能。

Objective To evaluate the effect of arthroscopic reshaping procedures on symptomatic discoid meniscus and compare the outcomes between children and adults. Methods The medical records of those who had undergone arthroscopic reshaping procedures for symptomatic discoid meniscus between January 1997 to December 2000 were reviewed. Results Fifty-four patients had been followed up more than 7 years, including 38 children and 16 adults. The average Lysholm score increased from （65.0 ± 10. O） preoperatively to （72.0 ± 10.0） postoperatively. The average 8.2-year follow-up showed no obvious clinical symptoms and signs or osteoarthritis in children. Fourteen knees in adults were found osteoarthritis on X-ray film, of which 6 showed the symptoms and signs of osteoarthritis. Conclusion The midterm efficacy of arthroscopic surgery for symptomatic discoid menisci and the occurrence of postoperative osteoarthritis are related to age and injury course.