关节镜下治疗各型膝关节脱位的中期疗效评价

Evaluation on medium-term results of arthroscopic treatment for various knee dislocation

目的 探讨关节镜下治疗各型膝关节脱位的可行性及中期临床疗效。方法 回顾性分析2007年2月—2012年8月收治的35例膝关节脱位患者的临床资料。按照Schenck分型：KD-Ⅱ型4例,KD-ⅢL型6例,KD-ⅢM型18例,KD-Ⅳ型2例,KD-Ⅴ型5例。根据Lysholm功能评分、Tegner评分、膝关节活动度及膝关节稳定性对手术前后患膝功能进行评估,并采用配对t检验统计分析。结果 所有患者均获随访,平均随访24.8个月（6～48个月）。末次随访时,Lysholm膝关节功能评分由术前（36.7±5.7）（0～70）分提高至（86.5±11.2）（49～100）分,Tegner膝关节运动水平评分由术前（0.8±0.6）（0～2）分提高至（5.4±1.2）（3～6）分,膝关节关节活动度由术前73.2°±15.1°（15°～125°）提高至120.1°±7.3°（90°～135°）,差异均有统计学意义（P值均〈0.05）。结论 关节镜下治疗各型膝关节脱位是治疗膝关节脱位的安全、有效方法,具体治疗策略应根据脱位分型以及膝关节损伤情况来制定。

Objective To discuss the feasibility and medium-term clinical curative effect of various knee dislocation treated by arthroscopy. Methods Clinical data of 35 patients with knee dislocation from February 2007 to August 2012 were analyzed retrospectively. According to Schenck classification system parting, there were 4 cases of KD-Ⅱ, 6 cases of KD-Ⅲ L, 18 cases of KD-Ⅲ M, 2 cases of KD-Ⅳ and 5 cases of KD-Ⅴ. After surgery, the knee functions of these patients were evaluated according to Lysholm score, Tegner score, stability and mobility of the knee joint. Results The mean follow-up period for all the patients was 24.8 months （6-48 months）. At the last follow-up, the score of Lysholm knee functional was increased from preoperative （36.7±5.7） （0-70） to （86.5±11.2） （49-100）, and the rating of Tegner knee movement level was improved from preoperative （0.8±0.6） （0-2） to （5.4±1.2 ）（3-6）. Knee joint activity was from preoperative 73.2°±15.1° （15°-125°） up to 120.1°±7.3° （90 °-135°）, the difference was statistically significant（P〈0.05）. Conclusions The method of using arthroscopy to treat knee dislocation is safe and effective, and treatment strategies should be formulated based on specific condition.