关节镜下成形术治疗内侧盘状半月板4例

Treatment of discoid medial meniscus with arthroscopic plastic surgery in 4 patients

目的探讨关节镜下成形术治疗内侧盘状半月板的疗效。方法2003年6月-2008年4月应用关节镜下成形术治疗内侧盘状半月板4例。采用膝关节前内侧和前外侧入路，用篮钳、刨削刀和射频刀消融成形术，保留半月板外周约6mm宽。关节镜下射频刀清理股骨髁和胫骨平台软骨损伤。结果4例患者随访时间平均35个月（10-70个月）。采用膝关节JOA评分标准评定疗效，术前平均47．5分（40～55分），术后随访平均813分（75～85分）。优3例，良1例。结论关节镜下确诊内侧盘状半月板后实施成形术能获得优良的治疗结果。

Objective To evaluate the effect of arthroscopic plastic operation on discoid medial meniscus. Methods From June 2003 to April 2008, 4 cases of discoid medial meniscus underwent arthroscopic plastic operation. Ablation was carried out with clamps, decorating and sharpening cutter or radiofrequency knife from an anteriomedial or an anteriolateral incision made on the knee joint. A 6mm peripheral rim of the meniscus was reserved. Arthroscopic removal of the injured meniscus and cartilage was performed with a radiofrequency knife. Results All the patients were followed up for an average period of 35 months. The JOA score was used to evaluate the therapeutic effect of arthroscopic plastic operation. The average JOA score was 47.5（40-55） and 81.3（75-85） before and after operation, respectively. Excellent and good effects were achieved in 3 cases and 1 case, respectively. Conclusion Rather good therapeutic effect can be achieved in treatment of discoid medial meniscus with arthroscopic plastic operation of meniscus.