关节镜下半月板部分切除术治疗膝关节半月板损伤的临床研究

Clinical study of arthroscopic partial meniscectomy for knee meniscus injury

目的探讨膝关节半月板损伤经关节镜下半月板部分切除术的治疗效果。方法回顾性分析新乡医学院第一附属医院骨科2013年8月—2016年8月收治的103例膝关节半月板损伤患者的临床资料,根据治疗方案将患者分为半月板成形术组(32例):男性19例,女性13例;致伤原因:道路交通伤19例,摔伤8例,高处坠落伤5例;非手术组(33例):男性20例,女性13例;致伤原因:道路交通伤18例,摔伤10例,高处坠落伤5例;半月板部分切除术组(38例):男性22例,女性16例;致伤原因:道路交通伤23例,摔伤9例,高处坠落伤6例。比较3组治疗前、治疗6个月、2年后的膝关节活动度、疼痛程度以及膝关节功能。结果半月板部分切除术组、半月板成形术组优良率均高于非手术组,且半月板部分切除术组高于半月板成形术组(P<0.05)。3组治疗6个月、2年后膝关节功能评分、膝关节活动度呈先升高后降低趋势(P<0.05);半月板成形术组、半月板部分切除术组治疗6个月、2年后膝关节功能评分、膝关节活动度均高于非手术组,且半月板部分切除术组高于半月板成形术组(P<0.05)。3组患者治疗6个月、2年后VAS评分呈先降低后升高趋势(P<0.05);半月板成形术组、半月板部分切除术组治疗6个月、2年后VAS评分均低于非手术组,且半月板部分切除术组低于半月板成形术组(P<0.05)。结论膝关节半月板损伤经关节镜下半月板部分切除术治疗,疗效确切,可有效改善患者膝关节活动度、膝关节功能,减轻机体疼痛感,具有临床应用价值。

Objective To investigate the clinical effect of arthroscopic partial meniscectomy for knee meniscus injury.Methods The clinical data of 103 patients with knee meniscus injury treated in our hospital from Aug.2013 to Aug.2016 were retrospectively analyzed.According to the treatment plan,the patients were divided into three groups.In the meniscus reshaping group(32 cases,meniscus reshaping group)were 19 males and 13 females,and the causes of injury were 19 of traffic accidents,8 of falls and 5 of high falling.In the non-surgical group(33 cases,non-surgical group)were 20 males and 13 females,and the causes of injury were:18 of traffic accidents,10 of falls and 5 of high falling.In the partial meniscus resection group(38 cases,partial meniscectomy group)were 22 male cases and 16 female cases,and the cause of injury included traffic accident in 23 cases,fall in 9 cases and high falling in 6 cases.The excellent and good rates of the three groups after 6 months of treatment were compared,and the range of motion,pain degree and knee function of the three groups before treatment,and at 6 months and 2 years after treatment were compared.Results The excellent and good rates of the partial meniscectomy group and meniscus reshaping group were higher than those of the non-surgical treatment group,and the partial meniscectomy group was higher than that of the meniscus reshaping group(P<0.05).After 6 months of treatment and 2 years of treatment,knee joint mobility and knee joint function score in three groups increased first and then decreased(P<0.05).After 6 months of treatment,knee joint mobility and knee joint function score in the partial meniscectomy group and meniscus reshaping group were higher than those in the non-surgical group,and those in the partial meniscectomy group were higher than those in the meniscus reshaping group(P<0.05).After 6 months and 2 years,the VAS scores of the three groups decreased first and then increased(P<0.05),which were lower in the partial meniscectomy group,the meniscus reshaping group than those of the non-surgical group after 6 months and 2 years,and were lower in the partial meniscectomy group than those of the meniscus reshaping group(P<0.05).Conclusion Arthroscopic partial meniscectomy is effective in the treatment of knee meniscus injury.It can effectively improve the range of motion of knee joint,knee function and relieve body pain.It has certain clinical value.