关节镜下手术治疗儿童膝关节盘状软骨

Arthroscopic management of discoid meniscus in children

目的 探讨儿童膝关节盘状半月板经关节镜手术治疗方法。方法 结合文献资料对1990年1月～1999年8月在我院行膝关节镜手术的49例52膝儿童膝关节盘状半月板进行系统回顾和分析研究。本组年龄5～14岁,平均年龄10.3岁。其中男性23例,女性26例,右膝22例,左膝24例,双膝3例。52膝均行膝关节镜检查,术中证实为膝关节外侧盘状半月板,其中40例伴有明显半月板撕裂,5例为Wrisberg韧带型盘状半月板。分别给以半月板改形术或半月板次全切术。结果 术后随访43例共45膝,随访时间平均2.9年(6个月～5年)。根据Ikeuchi标准评估,本组:优27膝,良16膝,一般2膝,差0膝。随访结果满意。结论 关节镜术为儿童膝关节盘状半月板诊断及治疗的有效方法。按Watanabe关节镜下盘状软骨分型,更有利于临床手术方式选择。儿童盘状半月板的关节镜治疗以改形术为主,根据术中情况,来决定留存范围。对Wrisberg韧带型半月板宜行次全切术,而对无症状的盘状半月板可暂不手术治疗。

Objective To evaluate the arthroscopic management of lateral discoid meniscus in chil- dren. Methods Forty-nine children (male 23, female 26) with 52 lateral discoid menisci that underwent arthroscopy management from Jan. 1990. - Aug. 1999. were retrospectively reviewed. The age ranged from 5～14 years (mean 10.3 years). There were right side in 22,left side in 24 and bilateral in 3. Forty knees were torn, 5 knees were belonged to Wrisberg-type discoid menisci. Meniscoplasty or subtotal menis- cectomy was performed on these patients based on classification and degree. Results Forty-three children (45 knees) were followed-up for an average of 2.9 years (6 months～5 years). According to Ikeuchi's Grading, 27 knees got excellent outcome, 16 were good, and 2 fair. Conclusion Arthroscopic treatment is an effective technique to children with discoid meniscus.