关节镜下半月板部分切除术治疗膝关节半月板损伤的手术效果

Surgical effect of arthroscopic partial meniscectomy in the treatment of knee meniscus injury

目的探讨关节镜下半月板部分切除术治疗膝关节半月板损伤的疗效与安全性。方法选取2017年1月至2019年12月本院收治的67例膝关节半月板损伤患者作为研究对象,按照随机数字表法分为实验组(n=34)与对照组(n=33)。实验组行关节镜下半月板部分切除术,对照组行关节镜下半月板修复术,比较两组手术成功率、美国纽约特种外科医院(HSS)膝关节功能评分、Lysholm量表评分及并发症发生情况。结果两组手术成功率均为100%,组间比较差异无统计学意义。术后,两组疼痛、功能、活动度、稳定性评分及总分均高于术前,差异有统计学意义(P<0.05),两组肌力、膝畸形与术前比较差异无统计学意义;术后,实验组功能、活动度评分及总评分均高于对照组,差异有统计学意义(P<0.05),两组疼痛、肌力、膝畸形、稳定性评分比较差异无统计学意义。术后,两组跛行、支撑、交锁、不稳定、疼痛、肿胀、爬楼梯、下蹲评分及总分均高于术前,差异有统计学意义(P<0.05),且实验组支撑、交锁、不稳定、肿胀评分及总分均高于对照组,差异有统计学意义(P<0.05),两组术后跛行、疼痛、爬楼梯、下蹲评分比较差异无统计学意义。两组均未见手术相关并发症。结论关节镜下半月板部分切除术与半月板修复术均可安全、有效的治疗半月板损伤,改善疼痛、跛行等临床症状,但关节镜下半月板部分切除术在提高膝关节功能方面更具临床优势,值得临床推广应用。

Objective To investigate the efficacy and safety of arthroscopic partial meniscectomy in the treatment of knee meniscus injury.Methods 67 patients with knee meniscus injury admitted to our hospital from January 2017 to December 2019 were selected as the study subjects,and they were divided into the experimental group(n=34)and the control group(n=33)according to random number table method.The experimental group underwent arthroscopic partial meniscectomy,and the control group underwent arthroscopic meniscus repair,the successful rate of surgery,the knee function score of New York Hospital for Special Surgery(HSS),the score of Lysholm scale and the incidence of complications were compared between the two groups.Results The successful rate of surgery was 100.0%in the two groups,and there was no significant difference between the two groups.After surgery,the pain,function,range of motion,stability scores and total score of the two groups were higher than those before surgery,and the differences were statistically significant(P<0.05),there was no statistically significant difference in muscle strength and knee deformity between the two groups;after surgery,the function,range of motion scores and total score in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05),there was no statistically significant difference in pain,muscle strength,knee deformity and stability scores between the two groups.After surgery,the lameness,support,interlocking,instability,pain,swelling,stair climbing,squatting scores and total score of the two groups were higher than those before surgery,and the differences were statistically significant(P<0.05),the support,interlocking,instability,swelling scores and total score in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05),and there were no significant differences in lameness,pain,stair climbing and squat scores between the two groups.There were no surgery-related complications in the two groups.Conclusion Both arthroscopic partial meniscectomy and meniscal repair can safely and effectively treat meniscal injuries and improve clinical symptoms such as pain and claudication,however,arthroscopic partial meniscectomy has more clinical advantages in improving knee joint function,and is worth promotion and application.