关节镜下青少年盘状半月板的治疗

Arthroscopic meniscectomy of discoid lateral meniscus in adolescents

目的探讨关节镜下半月板成形术治疗青少年盘状半月板的疗效。方法自2005年1月至2010年12月,关节镜下治疗43例(47膝)膝关节盘状半月板损伤患者,男25例,女18例;平均年龄16.5±4.6岁;左21例,右26例,双膝4例;内侧盘状半月板3例,外侧盘状半月板44例,术前病程13.6±3.9月。结果术后平均随访27.3±8.9月(16～58月),Ikeuchi膝关节功能评分标准,优41例(87.2%),良2例(4.3%),可4例(8.5%),差0例。术前lysholm评分32～75(61.2±11.4)分,终末随访时89～100(96.3±4.5)分,较术前有显著提高(t=19.634,P<0.01)。结论关节镜下治疗青少年盘状半月板疗效满意;早期治疗有利于减少骨关节炎的发生。

Objective To discuss the efficacy of arthroscopic meniscectomy of discoid lateral meniscus in adolescents.Methods 43 patients（47 knees） who suffered from injury of discoid lateral meniscus between January 2005 and December 2010.The patients＇ mean age at the time of operation was 16.5 years,and there were 25 male and 18 female patients,21 left knees and 26 right knees,4 patients suffered from symptomatic bilateral discoid meniscus,and 3 patients have medial discoid meniscus and 44 patients have lateral discoid meniscus.The mean duration of symptoms before surgery was 13.6±3.9 months.Results Results were evaluated according to the Lysholm and Ikeuchi Knee Scoring Scale.The preoperative Lysholm mean score is 61.2±11.4,compared to 96.3±4.5 postoperatively.Ikeuchi scale were： 41 excellent（87.2%）,2 good（4.3%）,4 poor（8.5%） and no bad.Conclusion Arthroscopic meniscectomy of discoid lateral meniscus in adolescents is effective and safe,early surgery could avoid the occurrence of osteoarthritis.