关节镜下半月板成形缝合治疗盘状半月板损伤

Arthroscopic meniscoplasty and suture for the treatment of discoid meniscus injury

目的评价关节镜辅助下半月板成形缝合治疗盘状半月板损伤的临床疗效。方法回顾性分析湘雅常德医院2017年11月至2020年2月收治的42例盘状半月板损伤患者的临床资料。根据半月板撕裂部位和类型,采取关节镜下半月板成形缝合技术(Fast-Fix全内缝合、借助腰穿针从外向内缝合及肩关节缝合钩穿线缝合)进行手术治疗。结果平均随访时间18.7个月(12~24个月)。Lysholm评分、国际膝关节评分委员会(IKDC)评分和膝关节活动度分别由术前(59.6±4.4)分、(62.2±4.6)分、(106.0±14.8)°提高至末次随访的(91.9±1.9)分、(83.9±3.7)分、(138.8±3.1)°,手术前后比较,差异均有统计学意义(P<0.05)。末次随访时优31例、良8例、可3例,优良率为93%。随访期间患者无关节交锁、不稳症状,无下肢深静脉血栓、关节内感染并发症发生。结论关节镜下半月板成形缝合治疗盘状半月板损伤能够最大程度地保留半月板,促进膝关节功能恢复,近期疗效满意。

Objective To evaluate the clinical effect of arthroscopic meniscal plasty and suture in the treatment of discoid meniscus injury.Methods Clinical data of 42 patients with discoid meniscus injury treated from November 2017 to February 2020 in Xiangya Changde Hospital were retrospectively analyzed.According to the location and types of discoid meniscus tear,patients underwent arthroscopic meniscoplasty and suture techniques,including Fast-Fix all inside suture,outside-in suture with help of lumbar puncture needle,and threading suture with help of shoulder joint suture hook.Results All patients were followed up for 12 to 24 months,with a mean of 18.7 months.Lysholm scores,International Knee Documentation Committee(IKDC)scores,and range of motion of knee joint were improved from(59.6±4.4),(62.2±4.6)points and(106.0±14.8)degree preoperatively to(91.9±1.9),(83.9±13.7)points and(138.8±3.1)degree at the latest follow-up respectively,which showing statistical differences between preoperation and postoperation(P<0.05).At the latest follow-up,clinical outcome were excellent in 31 cases,good in 8 and fair in 3 cases,with the excellent and good rate of 93%.During the follow-up,there were no joint interlocking or instability symptoms,also,no complications of deep venous thrombosis in lower extremity or intra-articular infection were found.Conclusion Arthroscopic meniscal plasty and suture for discoid meniscus injury can reserve enough meniscus as much as possible,improve the function recovery of knee joint,and therefore achieve a satisfactory short-term effects.