应用可调袢微型钛板重建内侧半月板后根止点

Insertion reconstruction of posterior root tears of the medial meniscus in the knee by miniature titanium plate with adjustable tab

目的:探讨应用可调袢微型钛板重建内侧半月板后根止点的临床效果。方法:2019年9月至2021年6月在关节镜辅助下以可调袢微型钛板对36例单侧膝关节内侧半月板后根损伤(MMPRT)患者进行后根止点修复重建。患膝全部合并有不同程度的骨关节炎,其X线片Kellgren-Larence分级:1级15膝,2级21膝。患者于术前及术后随访时进行膝关节功能与退变情况的检测,其指标包括疼痛视觉模拟评分(VAS)、国际膝关节文献委员会(IKDC)评分、Lysholm评分、Kellgren-Larence分级与内侧半月板外凸情况。结果:36例患者获得14~36个月随访,平均(25.0±6.0)个月。末次随访时,患者膝关节VAS评分为0.6(0,1.0)分,IKDC评分为(58.2±4.1)分,Lysholm评分为88.7(85.3,92.0)分,与术前比较差异均有统计学意义(P<0.001)。末次随访时的Kellgren-Larence分级与内侧半月板外凸情况均比术前略差,但差异无统计学意义(P>0.05)。结论:应用可调袢微型钛板重建内侧半月板后根止点的临床疗效良好,可有效改善内侧半月板的稳定性,延缓骨关节炎的进展。

Objective:To evaluate clinical outcomes of insertion reconstruction of posterior root tear of the medial meniscus in the knee by miniature titanium plate with adjustable tab.Methods:A total of 36 patients with medial meniscus posterior root tear(MMPRT)in the unilateral knee underwent arthroscopic insertion reconstruction by miniature titanium plate with adjustable tab from September 2019 to June 2021 and were enrolled in this study.All the patients concomitantly suffered from varying degrees of osteoarthritis,including 15 knees at grade 1 and 21 knees at grade 2 according to Kellgren-Larence classification.Visual analog scale(VAS)score,International Knee Documentation Committee(IKDC)score,Lysholm score,Kellgren-Larence grade and medial meniscus extrusion were applied to evaluate knee functions and degeneration preoperatively and postoperatively.Results:The mean follow-up period was(25.0±6.0)months(range,14-36 months)in the patients.The VAS knee score,IKDC score and Lysholm knee score was 0.6(0,1.0),58.2±4.1 and 88.7(85.3,92.0)respectively at the last follow-up,which were statistically different from preoperative ones(P<0.001).The Kellgren-Larence grading and medial meniscus protrusion at the last follow-up were slightly worse than preoperative ones,but the differences were not statistically significant(P˃0.05).Conclusions:Insertion reconstruction of posterior root tear of the medial meniscus in the knee by miniature titanium plate with adjustable tab is a good treatment option.It can effectively improve the stability of medial meniscus and delay the progress of orthoarthritis.