关节镜下单线双位点套扎缝合治疗内侧半月板后根部损伤

Arthroscopic single thread double site ligation and suture technique in the treatment of medial meniscus posterior root tear

目的探讨应用关节镜下单线双位点套扎缝合技术治疗内侧半月板后根部损伤(medial meniscus posterior root tear,MMPRT)的临床效果。方法选择河北医科大学第三医院收治的行关节镜下单线双位点套扎缝合治疗的MMPRT患者17例17膝。X线片Kellgren-Larence分级情况为0级2例,1级5例,2级10例。患者于术前及术后随访时进行相关功能评分与膝关节退变情况检测,包括疼痛视觉模拟评分(visual analogue scale,VAS)、国际膝关节文献委员会(international knee documentation committee,IKDC)评分、Lysholm评分、X线片Kellgren-Larence分级及内侧半月板外凸数值。结果17例患者获得13~20个月的随访,平均(16.28±3.54)个月。末次随访时膝关节VAS评分[1.00(1.00)分]低于术前[5.00(1.00)分],IKDC评分、Lysholm评分及内侧半月板外凸均值[(60.29±3.98)分、(89.88±4.11)分及(3.08±0.19)mm]高于术前[(38.82±2.48)分、(51.65±4.27)分及(2.98±0.11)mm],差异有统计学意义(P<0.001)。末次随访时的X线片Kellgren-Larence分级与术前比较,差异无统计学意义(P>0.05)。结论应用关节镜下单线双位点套扎缝合治疗MMPRT的临床疗效良好,同时具有良好的安全性与可操作性。

Objective To evaluate clinical effect of arthroscopic single thread double site ligation and suture technique in the treatment of medial meniscus posterior root tear(MMPRT).Methods In total,17 knees from 17 patients with MMPRT were selected and treated with arthroscopic single thread double site ligation and suture in the Third Hospital of Hebei Medical University.The Kellgren-Larence grading of 17 knees on X-ray was grade 0 in 2 patients,grade 1 in 5 patients,and grade 2 in 10 patients.During preoperative and postoperative follow-up,patients were evaluated for relevant functional scores and knee joint degeneration,including visual analogue scale(VAS)pain score,international knee documentation committee(IKDC)score,Lysholm score,X-ray Kellgren-Larence grading,and medial meniscus extrusion(MME)value.Results Seventeen patients were followed up for 13 to 20 months,with an average of(16.28±3.54)months.At the last follow-up,the knee joint VAS score[1.00(1.00)points]was lower than that[5.00(1.00)points]before operation,while the IKDC score,Lysholm score,and MME value were[(60.29±3.98)points,(89.88±4.11)points,and(3.08±0.19)mm]respectively,which were higher than those[(38.82±2.48)points,(51.65±4.27)points,and(2.98±0.11)mm]before operation,with statistical significance(P<0.001).At the last follow-up,there was no significant difference in the Kellgren-Lawrence grading of X-ray films compared with preoperative levels(P>0.05).Conclusion Arthroscopic single thread double site ligation and suture for the treatment of MMPRT has good clinical efficacy,as well as good security and operability.