关节镜下治疗外侧半月板撕裂合并不同程度软骨损伤的疗效研究

Study on the Curative Effect of Arthroscopic Treatment of Lateral Meniscus Tear Combined with Different Degrees of Cartilage Injury

目的研究关节镜下治疗外侧半月板撕裂合并不同程度软骨损伤的疗效。方法选取2016年6月-2021年6月修水县第一人民医院收治的82例外侧半月板撕裂并软骨损伤患者,依据软骨损伤Outerbridge分级进行分组,OuterbridgeⅠ~Ⅱ级设为A组,OuterbridgeⅢ~Ⅳ级设为B组,均为41例。所有患者均给予关节镜下治疗,比较两组临床疗效、Lysholm膝关节评分、Tegner活动水平量表评分、疼痛症状[静态、动态疼痛视觉模拟评分(VAS)]、术后恢复时间(膝关节活动度恢复正常时间、活动后无疼痛时间)。结果A组治疗有效率高于B组(P<0.05);术后3个月,两组Lysholm、Tegner评分均高于术前,且A组低于B组(P<0.05);术后3个月,两组静、动态VAS评分均低于术前,且A组低于B组(P<0.05);A组膝关节活动度恢复正常时间、活动后无疼痛时间均短于B组(P<0.05)。结论关节镜下治疗外侧半月板撕裂并不同程度软骨损伤的疗效存在明显差异,其中OuterbridgeⅠ~Ⅱ级软骨损伤患者的治疗效果优于OuterbridgeⅢ~Ⅳ级软骨损伤患者,且膝关节功能及疼痛症状改善更为明显,术后恢复更快。

Objective To study the effect of arthroscopic treatment of lateral meniscus tear with different degrees of cartilage injury.Methods A total of 82 patients with lateral meniscus tear and cartilage injury admitted to the First People's Hospital of Xiushui County from June 2016 to June 2021 were selected and grouped according to the Outerbridge classification of cartilage injury.Outerbridge gradeⅠ-Ⅱwas set as group A,and Outerbridge gradeⅢ-Ⅳwas set as group B,with 41 patients in each group.All patients were given arthroscopic treatment.The clinical efficacy,Lysholm knee score,Tegner activity level scale score,pain symptoms[static and dynamic pain visual analogue score(VAS)],postoperative recovery time(knee activity recovery time,no pain time after activity)were compared between the two groups.Results The effective rate of treatment in group A was higher than that in group B(P<0.05).At 3 months after operation,Lysholm and Tegner scores of the two groups were higher than those before operation,and those in group A were lower than those in group B(P<0.05).At 3 months after operation,the static and dynamic VAS scores of the two groups were lower than those before operation,and those in group A were lower than those in group B(P<0.05).The recovery time of knee joint activity and pain-free time after activity in group A were shorter than those in group B(P<0.05).Conclusion There are significant differences in the efficacy of arthroscopic treatment of lateral meniscus tear and different degrees of cartilage injury.The therapeutic effect of patients with Outerbridge gradeⅠ-Ⅱcartilage injury is better than that of patients with Outerbridge gradeⅢ-Ⅳcartilage injury,and the improvement of knee joint function and pain symptoms is more obvious,and the postoperative recovery is faster.