关节镜下全内缝合修补外侧半月板桶柄样撕裂的疗效观察

Observation on the curative effect of total internal suture repair of lat eral meniscus with barrel handle tear under arthroscope

目的:探讨外侧半月板桶柄样撕裂(bucket handle tear,BHT)患者行关节镜下全内缝合修补的疗效。方法:研究对象为淮南东方医院集团广济医院骨科2021年10月至2022年9月住院治疗的10例外侧BHT患者。对这些患者均进行关节镜下全内缝合修补治疗(即对于关节镜下证实无复合撕裂且可复位的半月板红区、红白区损伤,均采用关节镜下全内半月板修补术缝合半月板),采用Lysholm评分系统评价患者术前及术后的膝关节功能,并统计其治疗优良率。结果:10例患者的术后随访时间为2~10个月,平均随访6个月,随访期间未见血管神经损伤及切口感染等并发症。10例患者的Lysholm评分:术前(47.6±15.8)分,术后(85.6±11.2)分,二者相比差异有统计学意义(P<0.001)。10例患者的治疗优良率为90.0%。结论:对于发生在红-红区或红-白区、累及半月板后角至前体部的大型外侧BHT,采用关节镜下全关节内缝合术对撕裂的半月板全长区域进行缝合,能够获得很好的临床疗效,患者创伤小、恢复快,是一种操作简便、安全有效的治疗方式。

Objective:To investigate the effect of arthroscopic total internal suture repair in patients with bucket handle tear(BHT)of lateral meniscus.Methods:The study subjects were 10 patients with exceptional BHT who were hospitalized in the Department of Orthopedics,Guangji Hospital,Huainan East Hospital Group from October 2021 to September 2022.Arthroscopic total internal suture repair was performed on all these patients(that is,total arthroscopic meniscus repair was used to suture the meniscus in the red and red and white areas of the meniscus without complex tear and could be reduced under arthroscopy).The knee joint function of the patients before and after surgery was evaluated by Lysholm scoring system,and the excellent and good rate of treatment was calculated.Results:The postoperative follow-up time of 10 patients was 2~10 months,the average follow-up time was 6 months,and no complications such as vascular nerve injury and incision infection were found during the follow-up.The Lysholm score of 10 patients was 47.6±15.8 before surgery and 85.6±11.2 after surgery,and the difference was statistically significant(P<0.001).The good and good rate of 10 patients was 90.0%.Conclusion:For large lateral BHT that occurs in the red-red or red-white area and involves the posterior Angle of meniscus to the anterior part,total intraarticular suture under arthroscopy can obtain good clinical efficacy,with little trauma and quick recovery,and is a simple,safe and effective treatment.