膝关节镜下盘状半月板损伤的治疗

Treatment of discoid meniscus injury under knee arthroscopy

目的分析膝关节镜下半月板切除术和半月板成形缝合术应用于半月板损伤的临床价值。方法本研究选取2016年7月～2018年2月我院病房收治的膝关节半月板损伤患者46例,对照组采取关节镜下半月板切除方案,实验组采取关节镜下半月板成形缝合方案,比较两组患者应用各自治疗措施后的临床疗效。结果实验组的手术所需时长(58.1±7.3)分显著长于对照组的(50.5±4.7)分,术后功能锻炼时长(27.2±6.8)d显著短于对照组的(37.2±7.8)d,实验组治疗效果优良率(91.30%)高于对照组(73.91%),差异有统计学意义(P <0.05)。实验组治疗前Lysholm分值为(61.2±7.6)分、膝关节IKDC评估分值为(53.4±6.5)分,随访半年后Lysholm分值为(87.5±8.1)分、IKDC分值为(83.7±9.3)分。对照组治疗前Lysholm分值为(60.3±8.7)分,IKDC分值为(54.6±7.1)分,随访半年后Lysholm分值为(77.1±8.4)分、IKDC分值为(73.4±7.1)分。治疗前两组患者的Lysholm分值及IKDC分值差异无统计学意义(P> 0.05),随访半年后,两组患者的Lysholm分值及IKDC分值均明显升高,但实验组的分值显著超过对照组,且差异有统计学意义(P <0.05)。结论关节镜下半月板成形缝合术应用于半月板损伤疗效确切,相对于常规半月板切除术更符合人体生物学理论,保留半月板基本结构及功能,有利于患者术后恢复,值得临床借鉴。

Objective To analyze clinical value of meniscectomy and meniscal forming suture under knee arthroscopy in discoid meniscus injury. Methods 46 patients with meniscus injury of knee joint who were admitted and treated in our wards of our hospital from July 2016 to February 2018 were selected in the study.The control group underwent meniscectomy and the experimental group underwent meniscal forming suture under knee arthroscopy. Clinical curative effects after treatment of patients in two groups were compared. Results The operation time in the experimental group was (58.1±7.3) min,significantly longer than that in the control group (50.5±4.7) min.Time for postoperative functional exercise in the experimental group was (27.2±6.8) days,significantly shorter than that in the control group (37.2±7.8) days.Excellent and good rate of curative effect in the experimental group was 91.30%,higher than that in the control group 73.91%.The difference was significant (P < 0.05).Before treatment,Lysholm score and knee joint IKDC score of the experimental group were respectively (61.2±7.6) and (53.4±6.5).After the followup for half a year,Lysholm score and knee joint IKDC score of the experimental group were respectively (87.5+8.1) and (83.7±9.3). Before treatment,Lysholm score and knee joint IKDC score of the control group were respectively (60.3±8.7) and (54.6±7.1).After the follow-up for half a year,Lysholm score and knee joint IKDC score of the control group were respectively (77.1±8.4) and (73.4±7.1).Differences in Lysholm score and knee joint IKDC score before treatment of patients in two groups had no statistical significance (P > 0.05).After the follow-up for half a year,Lysholm score and knee joint IKDC score were both significantly improved,while the scores in the experimental group were significantly higher than those in the control group.The difference was statistically significant (P < 0.05). Conclusion Application of meniscal forming suture under knee arthroscopy in meniscus injury has an accurate curative effect.Compared with the conventional meniscectomy,it is more in line with the biological theory of human body.It can retain the basic structure and function of meniscus,which is conducive to postoperative recovery of patients and is worthy of clinical reference.