关节镜下外侧盘状半月板成形术后残余半月板的大小与膝关节功能的关系

Relationship Between Residual Meniscus Size and Knee Function After Arthroscopic Meniscoplasty for Discoid Lateral Meniscus

目的:研究关节镜下外侧盘状半月板成形术后残余半月板的大小与患者膝关节功能的关系。方法:选取2018年6月—2020年6月柳州市中医医院(柳州市壮医医院)收治的因症状性外侧盘状半月板而接受关节镜下半月板成形术的患者80例(共85膝)作为研究对象,根据术后残余半月板体部的大小分为研究A组(40膝)、研究B组(45膝),研究A组后残余半月板体部宽度<6 mm;研究B组术后残余半月板体部宽度6~8 mm。两组患者均行关节镜下半月板成形术,并于术前、术后1个月、1年、2年进行膝关节日常功能评分(Lysholm评分)及国际膝关节文献委员会(IKDC)评分。结果:术后1个月、1年、2年,两组Lysholm评分高于术前,研究A组低于研究B组,差异有统计学意义(P<0.05);术后1年、2年,两组Lysholm评分高于术后1个月,差异有统计学意义(P<0.05);术后2年,两组Lysholm评分高于术后1年,差异均有统计学意义(P<0.05)。术后1个月、1年、2年,两组IKDC评分高于术前,研究A组低于研究B组,差异有统计学意义(P<0.05);术后1年、2年,两组IKDC评分高于术后1个月,差异有统计学意义(P<0.05);术后2年,两组IKDC评分高于术后1年,差异均有统计学意义(P<0.05)。结论:在关节镜下行外侧盘状半月板成形术时,应根据其损伤程度对切除量作出精确地判断,术后残余半月板越接近正常形态大小,则越有利于术后膝关节功能的恢复。

Objective:To study the relationship between the size of residual meniscus and the function of knee joint after arthroscopic meniscoplasty for discoid lateral meniscus.Methods:A total of 80 patients(85 knees)who underwent arthroscopic meniscoplasty for symptomatic lateral discoid meniscus who were admitted to Liuzhou Traditional Chinese Medicine Hospital(Liuzhou Zhuang Medical Hospital)from June 2018 to June 2020 were selected as the study subjects.They were divided into study group A(40 knees)and study group B(45 knees)according to the size of residual meniscus after operation.The width of residual meniscus body in study group A was<6 mm and that in study group B was 6-8 mm.All patients in two groups received arthroscopic meniscoplasty.The daily knee function score(Lysholm Score)and International Knee Documentation Committee(IKDC)score were rated before operation,at 1 month,1 year,and 2 years after operation.Results:At 1 month,1 year and 2 years after operation,the Lysholm score in the two groups was higher than that before operation,and the Lysholm score in study group A was lower than that in study group B,and the difference was statistically significant(P<0.05);At 1 year and 2 years after operation,the Lysholm score in the two groups was higher than that at 1 month after operation,and the difference was statistically significant(P<0.05);At 2 years after operation,the Lysholm score in the two groups was higher than that at 1 year after operation,and the difference was statistically significant(P<0.05).At 1 month,1 year and 2 years after operation,the IKDC score in the two groups was higher than that before operation,and the IKDC score in study group A was lower than that in study group B,and the difference was statistically significant(P<0.05);At 1 year and 2 years after operation,the IKDC score in the two groups was higher than that at 1 month after operation,and the difference was statistically significant(P<0.05);At 2 years after operation,the IKDC score in the two groups was higher than that at 1 year after operation,and the difference was statistically significant(P<0.05).Conclusion:In arthroscopic meniscoplasty for discoid lateral meniscus,the resection volume should be accurately judged based on the injury degree.When the postoperative residual meniscus is closer to the normal shape and size,it is more beneficial for the recovery of knee joint function after operation.