关节镜下经骨隧道缝合治疗膝关节外侧半月板后根部撕裂

Treatment for posterior root tear of lateral meniscus through bone tunnel suture under arthroscopy

目的:探讨关节镜下经骨隧道缝合治疗膝关节外侧半月板后根部撕裂的临床疗效。方法:自2012年1月至2014年12月,采用关节镜下经骨隧道缝合治疗23例膝关节外侧半月板后根部撕裂患者,其中男15例,女8例;年龄19～48(25.0±4.7)岁;左膝10例,右膝13例。记录患者并发症情况,术前及术后12个月采用Lysholm评分进行临床疗效评价,并采用VAS进行疼痛评价。术后12个月通过MRI检查外侧半月板损伤愈合情况。结果:23例患者获得随访,时间13～24(17.0±4.3)个月。术后无血管神经损伤及切口感染等并发症发生。术后12个月时19例患者膝关节活动度达到正常,4例患者存在膝关节活动受限。术后12个月Lysholm评分88.52±6.48,较术前46.12±7.35明显提高(P<0.05)。术后12个月VAS评分0.8±0.7,较术前4.3±1.6明显降低(P<0.05)。结论:采用关节镜下经骨隧道缝合治疗膝关节外侧半月板后根部撕裂,可有效缓解疼痛,降低术后并发症,临床疗效显著。

Objective:To evaluate clinical effects of posterior root tear of lateral meniscus through bone tunnel suture under arthroscopy.Methods:From January 2012 to December 2014,23 patients with posterior root tear of lateral meniscus repaired through bone tunnel suture under arthroscopy,including 15 males and 8 females,aged from 19 to 48 years old with an average age of(25.0±4.7)years old;10 knees on the left side and 13 knees on the right side.Complications were observed,Lysholm score before and after operation at 12 months were used to evaluate clinical results,and VAS score was applied to assess pain relief.MRI was used to check recovery outcomes of lateral meniscus injury.Results:All patients were followed up from 13 to 24 months with an average of(17.0±4.3)months.No injury of vessels,nerve and incision infection occurred.Motion of knee joint of 19 patients reached normal,4 patients manifested limited activity of knee joint at12 months after operation.Postoperative Lysholm score 88.52±6.48 at 12 months was higher than that of before operation 46.12±7.35;Postoperative VAS score 0.8±0.7 at 12 months was lower than that of before operation 4.3±1.6.Conclusion:Bone tunnel suture under arthroscopy for the treatment of posterior root tear of lateral meniscus could relieve pain,decrease postoperative complications and obtain good clinical efficacy.