关节镜下缝合修复3度半月板损伤的效果及对膝关节本体感觉的影响

The effect of 3 degree meniscus injury repaired by arthroscopic suture and the effect on the body sensation of knee joint

目的探究与分析关节镜下缝合修复3度半月板损伤的效果及对膝关节本体感觉的影响。方法选取哈尔滨医科大学附属第一医院自2015年5月～2017年5月收治的88例3度半月板损伤患者,采取随机数字表法分为对照组与观察组,每组各44例,对照组给予关节镜下由外向内缝合治疗,观察组给予关节镜下全内缝合治疗,对比两组患者膝关节半月板损伤后IKDC评分、Lysholm评分、视觉模拟量表(VAS)评分、Barrett优秀率、并发症发生率及随访1年患者的膝关节本体感觉。结果两组治疗后与本组治疗前比较IKDC评分、Lysholm评分升高,VAS评分降低,观察组治疗后与对照组治疗后比较,IKDC评分、Lysholm评分较高,VAS评分较低,差异有统计学意义(P <0.05)。观察组与对照组比较Barrett优秀率较高,切口感染、神经血管损伤发生率较低,差异有统计学意义(P <0.05)。两组术后6、12个月较术前测试角度在15°、45°及75°时膝关节本体感觉测试差值降低,术后12个月与术后6个月相比测试角度在15°、45°及75°时膝关节本体感觉测试差值较低,差异有统计学意义(P <0.05)。术后6、12个月观察组与对照组比较,膝关节本体感觉测试差值降低更加显著,差异有统计学意义(P <0.05)。结论关节镜下全内缝合治疗3度半月板损伤能够获得良好的临床效果,并发症发生率较低,能够有效改善膝关节本体感觉,预后较好。

Objective To explore and analyze the effect of arthroscopic suture in repairing the 3 degree meniscus injury and the effect on the body sensation of the knee joint. Methods A total of 88 cases with 3 degree of meniscus injury treated in the First Affiliated Hospital of Harbin Medical University from May 2015 to May 2017 were selected, all the patients were divided into control group and observation group by random number table method, with 44 cases in each group. The control group was given the outside-in suture treatment under arthroscope, and the observation group was given the total internal suture treatment under arthroscope. IKDC scores, Lysholm scores, visual analogue scale (VAS) scores, Barrett excellent rate, incidence of complications and 1 year follow-up of knee proprioception of patients were compared between the two groups. Results After treatment, IKDC scores and Lysholm scores increased and VAS scores decreased in the two groups compared with those before treatment;compared with the control group, IKDC scores and Lysholm scores were higher and VAS scores were lower after treatment in the observation group, and the differences were statistically significant (P < 0.05). Compared with the control group, the excellent rate of Barrett was higher in the observation group, while the incidence of incision infection and nerve vessel injury were lower, the differences were statistically significant (P < 0.05). After operation for 6 months, 12 months, the testing Angle in 15°, 45° and 75° of knee proprioception test were lower than those before treatment, testing Angle in 15°, 45° and 75° of knee proprioception test were lower after operation for 12 month than those after operation for 6 months, the differences were statistically significant (P < 0.05). The testing Angle in 15°, 45° and 75° of knee proprioception test decreased more significant in the observation group postoperative 6 months and 12 months than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion The treatment of 3 degree meniscus injury with total internal suture under arthroscope can achieve good clinical effect, which has a lower incidence of complications and can effectively improve knee proprioception with good prognosis.