关节镜下double-needle缝线修复混合型半月板撕裂

EFFECTIVENESS OF DOUBLE-NEEDLE SUTURE FOR MIXED MENISCUS TEAR REPAIR UNDER ARTHROSCOPE

目的探讨关节镜下采用double-needle缝线修复混合型半月板撕裂的疗效。方法 2006年4月-2011年1月,关节镜下采用double-needle缝线修复22例单膝混合型半月板撕裂。男14例,女8例;年龄18～41岁,平均31.3岁。均为运动损伤。受伤至入院时间为2 d～4年,中位时间11个月。膝关节功能根据国际膝关节文献委员会(IKDC)评分标准为(42.5±15.2)分,Lysholm评分为(45.5±13.5)分,Tegner评分为(2.9±1.6)分。17例合并前交叉韧带损伤。结果术后切口均Ⅰ期愈合,无神经、血管损伤。患者均获随访,随访时间12～48个月,平均27.6个月。按照Barrett等的评定标准,19例半月板临床愈合,临床愈合率86%。末次随访时,患者膝关节活动度均恢复正常,IKDC评分为(77.1±8.9)分,Lysholm评分为(79.8±9.9)分,Tegner评分为(6.8±1.6)分,与术前比较差异均有统计学意义(P<0.05)。结论关节镜下使用double-needle缝线由内向外修复混合型半月板撕裂固定牢固、疗效肯定。

Objective To investigate the effectiveness of double-needle suture for mixed meniscus tear repair under arthroscope.Methods Between April 2006 and January 2011,22 patients with mixed meniscus tear were treated with doubleneedle suture under arthroscope.There were 14 males and 8 females,aged 18-41 years（mean,31.3 years）.All injuries were caused by sports.The time between injury and admission ranged from 2 days to 4 years（median,11 months）.International Knee Documentation Committee（IKDC） score was 42.5 ± 15.2,Lysholm score was 45.5 ± 13.5,and Tegner score was 2.9 ± 1.6.Seventeen cases complicated with anterior cruciate ligament injury.Results Healing of incision by rst intention was achieved in all patients.No injury of nerve and blood occurred.The patients were followed up 12-48 months with an average of 27.6 months.According to Barrett et al.standard,19 cases（86%） got clinical healing.The IKDC,Lysholm,and Tegner scores were improved to 77.1 ± 8.9,79.8 ± 9.9,and 6.8 ± 1.6 respectively at last follow-up,showing signi cant differences when compared with preoperative scores（P 0.05）.Conclusion Arthroscopic meniscus repair using double-needle suture can provide good effectiveness because it has high rmness.