关节镜下半月板成形术治疗膝关节半月板损伤患者的效果观察及对Lysholm评分、关节生理功能的影响

Effect of Arthroscopic Meniscus Plasty in the Treatment of Knee Meniscus Injury and Its Influence on Lysholm Score and Physiological Function of the Joint

目的探讨关节镜下半月板成形术治疗膝关节半月板损伤患者的效果及对Lysholm评分、关节生理功能的影响。方法选取2017年9月—2020年2月在本院行关节镜下治疗的膝关节半月板损伤106例患者,据治疗方法不同分为观察组及对照组各53例,观察组采用关节镜下半月板成形术治疗,对照组采用关节镜下半月板切除术治疗。比较2组术后临床疗效和手术前后疼痛程度、关节活动度、膝关节功能及生活质量改善情况;术后随访6个月,了解2组术后并发症发生情况。结果术后观察组总有效率显著高于对照组(P<0.05);术后,2组视觉模拟评分法(visual analogue score,VAS)评分明显降低,关节活动度及Lysholm评分、国际膝关节评分委员会(international knee documentation committee,IKDC)膝关节主观功能评分明显升高,且术后观察组VAS评分下降程度、关节活动度及Lysholm评分、IKDC膝关节主观功能评分升高程度均大于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组术后改良美国特种外科医院膝关节总评分明显高于对照组(P<0.01);术后,2组世界卫生组织生存质量测定量表简表(World Health Organization quality of life scale-brief form questionnaire,WHOQOL-BREF)社会功能、物质生活、躯体功能、心理功能评分均明显升高,且观察组术后WHOQOL-BREF量表各领域评分均显著高于对照组,差异均有统计学意义(P<0.05或P<0.01);随访期间2组均未发现明显并发症。结论对膝关节半月板损伤患者行关节镜下半月板成形术治疗,具有令人满意的临床效果,并且可以有效改善患者疼痛程度,促进患膝关节生理功能恢复,提高患者生活质量。

Objective To investigate the effect of arthroscopic meniscus plasty in the treatment of knee meniscus injury and its influence on Lysholm score and physiological function of the joint.Methods From September 2017 to February 2020,106 patients with knee meniscus injury were selected and divided into observation group and control group according to different treatment methods,with 53 cases in each group.The observation group was treated with arthroscopic meniscus plasty,and the control group was treated with arthroscopic meniscus resection.The clinical efficacy,severity of pain,range of motion(ROM),knee function and quality of life were compared between the two groups before and after operation;the postoperative complications of the two groups were observed at 6 months of follow-up after surgery.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05),After the operation,the visual analogue score(VAS)scores of the two groups were significantly reduced,while the ROM and Lysholm score,and the subjective knee scores of the International Knee Documentation Committee(IKDC)were significantly increased.The degree of decrease in VAS score,ROM of the joint,Lysholm score,and IKDC subjective knee score in the observation group after surgery were all greater than those in the control group(P<0.05 or P<0.01).The postoperative total knee score of modified American special surgery hospital of the observation group was significantly higher than that of the control group(P<0.01).After operation,the scores of social function,material life,physical function and psychological function by World Health Organization quality of life scale-brief form questionnaire(WHOQOL-BREF)were significantly increased,and the scores in the observation group were significantly higher than those in the control group(P<0.05 or P<0.01).No obvious complications were found in the two groups during the follow-up period.Conclusion Arthroscopic meniscal plasty for patients with knee meniscus injury has satisfactory clinical effect,which can effectively improve the degree of pain,promote the recovery of physiological function of knee joint,and improve the quality of life of patients.