关节镜诊断与治疗膝盘状软骨损伤

Arthroscopic Diagnosis and Treatment of the Discoid Lateral Meniscus

目的 :探讨关节镜诊断和治疗膝盘状软骨的作用。方法 :1999～ 2 0 0 2年 2 6例盘状软骨损伤患者接受了关节镜治疗。在镜下按照Watanabe分型 :完全型 9例 ,不完全型 17例 ,未发现Wrisberg型。按照盘状软骨损伤范围 :一度损伤 19例。二度损伤 7例。其中部分切除 13例 ,次全切除 6例 ,全切除术 7例。结果 :2 2例获半年以上的随访 ,采用Ikeuch膝关节评分标准评定疗效 :优 15例 ,良 5例 ,一般 2例 ,无术后功能差的病例。结论 :盘状软骨镜下切除的方式取决于盘状软骨的类型以及损伤的范围。一度损伤者可选择成形术 ,特厚型盘状软骨损伤可选择次全切除术 ,二度损伤及Wrisberg型者宜行全切除术。

Objective:To evalute for clinical results of arthroscopic diagnosis and meniscectomy of the discoid lateral meniscus syndrome.Methods:Twenty six patients who had discoid lateral menisci underwent arthroscopic lateral meniscectomy from 1999 to 2002.The patients were categorized according to Watanabe's classifications:complete(9 knees),incomplete(17 knees),and no Wrisberg-type lesions were noted.According to the range of lateral meniscus lesions,it were classified arthroscopically as 1 degree lesions (19 knees) and 2 degree lesions(7 knees).At arthroscopy,19 torn discoid lateral meniscuses were modified to normal semilunar shape.Seven were totally resected.Results:Of the 26 knees,22 underwent a follow-up evaluation.Using Ikeuchi's knee scale,20 cases(90.9%)had either excellent or good ratings,and 2 (9.1%)received fair ratings.There were no poor outcomes.Conclusion:The extent of the meniscectomy depends on the type of discoid meniscus and the range of the tear.The authors suggest that a partial meniscectomy would be performed in the case who had 1 degree lesions of the discoid lateral meniscus.Total meniscectomy would be performed in 2 degree lesions and Wrisberg-type lesions.