膝关节镜下内侧副韧带不同松解方式在内侧半月板后角损伤治疗中的应用对比

A COMPARISON OF DIFFERENT KNEE ARTHROSCOPIC MEDIAL COLLATERAL LIGAMENT RELEASE TECHNIQUES IN TREATMENT OF MEDIAL MENISCUS POSTERIOR HORN INJURY

目的探究膝关节镜下不同内侧副韧带松解方式治疗内侧半月板后角损伤患者的效果及预后。方法选取2021年6—8月就诊于我院运动医学科的内侧半月板后角损伤需手术治疗的患者54例,根据病情及患者意愿分为A组(行膝关节镜下经皮由外向内浅层松解术)和B组(行膝关节镜下经前内侧入路由内向外松解术)。记录并比较两组患者的手术时间及术后第1、3、12个月的随访情况,包括局部症状持续时间、膝关节疼痛视觉模拟评分、膝关节Lysholm评分量表评分、国际膝关节评分委员会评分及膝关节运动评分。结果两组患者手术时间比较无显著差异(P>0.05),但B组患者的局部症状持续时间显著短于A组(t=11.950,P<0.05)。重复测量设计方差分析结果示,时间对患者术后各项膝关节功能评分有影响显著(F时间=1805.492~2715.143,P<0.05),其中与术后1个月时相比,A、B两组患者在术后第3、12个月时的各项膝关节功能评分均显著性升高(F=700.701~1557.491,P<0.05)。但两组患者术后各随访时间点膝关节功能评分比较无明显差异(P>0.05)。结论对于单纯内侧半月板后角损伤患者,有明确把握前提下推荐使用膝关节镜下经前内侧入路由内向外浅层松解术。

Objective To explore the effectiveness of different knee arthroscopic medial collateral ligament release techniques in the treatment of patients with medial meniscus posterior horn injury and their prognoses.Methods A total of 54 patients with medial meniscus posterior horn injury who underwent surgical treatment at the Department of Sports Medicine in our hospital from June to August 2021 were enrolled.They were divided into group A(who underwent knee arthroscopic percutaneous outside-in,superficial release)and group B(who underwent knee arthroscopic inside-out,anteromedial release)based on the conditions and wishes of the patients.The two groups of patients were recorded and compared for surgical duration and follow-up outcomes of the following indices at 1,3,and 12 months after surgery:local symptom duration,visual analogue score of knee pain,Lysholm score of knee joints,International Knee Documentations Committee Rating System-based score,and knee joint range of motion score.Results There was no significant difference in surgical duration between the two groups of patients(P>0.05),but the local symptom duration in group B was significantly shorter than that in group A(t=11.950,P<0.01).The results of repeated measures analysis of variance showed that time had a significant impact on postoperative knee joint function scores of the patients(F time=1805.492-2715.143,P<0.05).Compared with the scores 1 month after surgery,knee joint function scores of the patients in groups A and B significantly improved at 3 and 12 months after surgery(F=700.701-1557.491,P<0.05).However,there were no significant differences in knee joint function scores between the two groups of patients at each follow-up time point after surgery(P>0.05).Conclusion For patients with simple medial meniscus posterior horn injury,it is recommended to use knee arthroscopic anteromedial inside-out,superficial release if the surgeons are confident of the condition.