关节镜下缝合及部分切除治疗慢性半月板Ⅲ度损伤短期疗效比较

摘要/Abstract

摘要： 目的探讨关节镜下缝合及部分切除治疗慢性半月板Ⅲ度损伤的短期疗效。方法回顾性分析2019年6月—2021年6月南京江北医院收治的膝关节慢性半月板Ⅲ度损伤的患者67例,按照治疗方案不同分为缝合组（30例）和部分切除组（37例）,其中缝合组进行关节镜下膝关节半月板缝合治疗,部分切除组进行关节镜下膝关节半月板部分切除治疗,记录两组患者术前及术后1个月、3个月、6个月及末次随访时的膝关节Lysholm评分、国际膝关节文献委员会膝关节评估表（ICDK）评分、疼痛视觉模拟评分（VAS）评分,评估两组患者末次随访时膝关节功能的优良率。结果所有患者均进行6~18个月随访,平均随访时间（13.51±4.32）个月。术后1个月、3个月、6个月及末次随访时,缝合组Lysholm评分、IKDC评分均高于部分切除组,差异有统计学意义（P<0.05）。术后1个月、3个月时,缝合组患者VAS评分低于部分切除组,差异有统计学意义（P<0.05）。术后6个月及末次随访时,两组患者VAS评分比较,差异无统计学意义（P>0.05）。末次随访时,两组患者Lysholm评分、IKDC评分高于术前,VAS评分均低于术前,差异有统计学意义（P<0.05）。缝合组患者术后优良率高于部分切除组,但差异无统计学意义（P>0.05）。结论关节镜下膝关节半月板缝合和膝关节半月板部分切除均可有效治疗膝关节慢性半月板Ⅲ度损伤,但半月板缝合后的短期临床效果较好。

关键词: 慢性半月板损伤, 半月板缝合术, 半月板部分切除术, Lysholm评分, IKDC评分

Abstract: Objective To investigate the short-term efficacy of arthroscopic suture and partial meniscectomy in the treatment of chronic Ⅲ degree meniscus injury. Methods A retrospective analysis was performed on 67 patients with chronic knee meniscus Ⅲ degree injury admitted to the Nanjing Jiangbei Hospital from June 2019 to June 2021, who were divided into suture group (n=30) and partial meniscectomy group (n=37) according to different treatment ways, and the suture group was treated with arthroscopic meniscus suture, and the partial meniscectomy group was treated with arthroscopic partial resection of the knee meniscus. The Lysholm score, IKDC score, and VAS score of the two groups were recorded before operation and at 1 month, 3 months, 6 months after operation and last follow-up, and the excellent and good rate of knee joint function at last follow-up of the two groups was evaluated. Results All patients received at least 6 months, with an average of (13.51±4.32) months. At 1 month, 3 months, 6 months and the last follow-up, the Lysholm scores of the suture group were better than those of the partial resection group, and IKDC scores were better than partial nephrectomy group, all the differences were statistically significant (P<0.05). At 1 month and 3 months after operation, VAS scores in the suture group were lower than those in the partial resection group, all the differences were statistically significant (P<0.05). There were no significant difference in VAS score between the two groups at 6 months after operation or at the last follow-up (P>0.05). At the last follow-up, the Lysholm scores of the two groups were better than those before operation and IKDC scores were better than those of preoperative, and VAS scores were better than those of preoperative, all the differences were statistically significant (P<0.05). At the last follow-up, the excellent and good rate of the suture group was higher than that of the Partial meniscectomy group, but the difference was not statistically significant (P>0.05). Conclusion Both arthroscopic meniscus suture and partial meniscectomy can effectively treat chronic Ⅲ degree meniscus injury of the knee joint, and the short-term clinical effect were better after meniscus suture.

Key words: chronic meniscus injury, meniscal suture, partial meniscectomy, lysholm score, IKDC score

中图分类号:

R687.4

邱福平, 徐士刚, 张磊, 王斌. 关节镜下缝合及部分切除治疗慢性半月板Ⅲ度损伤短期疗效比较[J]. 中华养生保健, 2023, 41(17): 1-4.

QIU Fu-ping, XU Shi-gang, ZHANG Lei, WANG Bin. Comparison of Short Curative Effects of Arthroscopic Suture and Partial Meniscectomy in the Treatment of Chronic Ⅲ Degree Meniscus Injury[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(17): 1-4.

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