临床阳性体征与膝关节半月板损伤的相关性研究

Correlation study on clinical positive signs and meniscus injury of knee joint

目的探究临床阳性体征与膝关节半月板损伤的相关性。方法回顾性分析2016年4月~2020年3月景德镇市第二人民医院骨科收治的120例膝关节半月板损伤患者临床资料,所有患者均进行临床查体、磁共振成像(MRI)及关节镜检查,比较各项查体试验对不同部位半月板撕裂诊断的准确度、敏感度。结果120例患者中,关节镜检出前角半月板撕裂23例,体部半月板撕裂51例,后角半月板撕裂46例。以关节镜检查结果为金标准,关节间隙压痛、碾磨试验对前角、体部的半月板撕裂敏感度高于后角;麦氏试验对体部、后角处的半月板撕裂敏感度高于前角;蹲鸭步试验对后角的半月板撕裂敏感度高于前角、体部,差异有统计学意义(P<0.05)。各查体试验在前角、体部、后角的半月板撕裂中的特异性比较,差异无统计学意义(P>0.05)。结论临床阳性体征与膝关节半月板损伤密切相关,可通过临床查体辅助判断半月板撕裂。

Objective To investigate the correlation between clinical positive signs and meniscus injury of knee joint.Methods The clinical data of 120 patients with meniscus injury of knee joint who were admitted in the Second People's Hospital of Jingdezhen from April 2016 to March 2020 were retrospectively analyzed.All the patients underwent clinical examination,magnetic resonance imaging(MRI)and arthroscopy.The accuracy and sensitivity of each test in different parts of meniscus tear were compared.Results Among 120 patients,23 cases of anterior horn meniscus tear,51 cases of body meniscus tear,and 46 cases of posterior horn meniscus tear were detected by arthroscopy.The results of arthroscopy were used as the gold standard,the joint space tenderness and grinding tests were more sensitive to meniscus tear at the anterior horn and body than that at posterior horn;McMurray's test was more sensitive to meniscus tear at the body and posterior horn than that at anterior horn;squatting down test was more sensitive to meniscus tear at posterior horn than that at anterior horn and body,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the specificity of each test in anterior horn body,and posterior horn meniscus tear(P>0.05).Conclusion Clinical positive signs are closely related to the meniscus injury of knee joint,and clinical examination can be used to assist in judging meniscus tear.