膝关节镜下盘状半月板损伤的治疗
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摘要
目的分析膝关节镜下半月板切除术和半月板成形缝合术应用于半月板损伤的临床价值。方法本研究选取2016年7月～2018年2月我院病房收治的膝关节半月板损伤患者46例,对照组采取关节镜下半月板切除方案,实验组采取关节镜下半月板成形缝合方案,比较两组患者应用各自治疗措施后的临床疗效。结果实验组的手术所需时长(58.1±7.3)分显著长于对照组的(50.5±4.7)分,术后功能锻炼时长(27.2±6.8)d显著短于对照组的(37.2±7.8)d,实验组治疗效果优良率(91.30%)高于对照组(73.91%),差异有统计学意义(P <0.05)。实验组治疗前Lysholm分值为(61.2±7.6)分、膝关节IKDC评估分值为(53.4±6.5)分,随访半年后Lysholm分值为(87.5±8.1)分、IKDC分值为(83.7±9.3)分。对照组治疗前Lysholm分值为(60.3±8.7)分,IKDC分值为(54.6±7.1)分,随访半年后Lysholm分值为(77.1±8.4)分、IKDC分值为(73.4±7.1)分。治疗前两组患者的Lysholm分值及IKDC分值差异无统计学意义(P> 0.05),随访半年后,两组患者的Lysholm分值及IKDC分值均明显升高,但实验组的分值显著超过对照组,且差异有统计学意义(P <0.05)。结论关节镜下半月板成形缝合术应用于半月板损伤疗效确切,相对于常规半月板切除术更符合人体生物学理论,保留半月板基本结构及功能,有利于患者术后恢复,值得临床借鉴。
Objective To analyze clinical value of meniscectomy and meniscal forming suture under knee arthroscopy in discoid meniscus injury. Methods 46 patients with meniscus injury of knee joint who were admitted and treated in our wards of our hospital from July 2016 to February 2018 were selected in the study.The control group underwent meniscectomy and the experimental group underwent meniscal forming suture under knee arthroscopy.Clinical curative effects after treatment of patients in two groups were compared. Results The operation time in the experimental group was(58.1±7.3) min,significantly longer than that in the control group(50.5±4.7) min.Time for postoperative functional exercise in the experimental group was(27.2±6.8) days,significantly shorter than that in the control group(37.2±7.8) days.Excellent and good rate of curative effect in the experimental group was 91.30%,higher than that in the control group 73.91%.The difference was significant(P < 0.05).Before treatment,Lysholm score and knee joint IKDC score of the experimental group were respectively(61.2±7.6) and(53.4±6.5).After the followup for half a year,Lysholm score and knee joint IKDC score of the experimental group were respectively(87.5+8.1)and(83.7±9.3). Before treatment,Lysholm score and knee joint IKDC score of the control group were respectively(60.3±8.7) and(54.6±7.1).After the follow-up for half a year,Lysholm score and knee joint IKDC score of the control group were respectively(77.1±8.4) and(73.4±7.1).Differences in Lysholm score and knee joint IKDC score before treatment of patients in two groups had no statistical significance(P > 0.05).After the follow-up for half a year,Lysholm score and knee joint IKDC score were both significantly improved,while the scores in the experimental group were significantly higher than those in the control group.The difference was statistically significant(P < 0.05).Conclusion Application of meniscal forming suture under knee arthroscopy in meniscus injury has an accurate curative effect.Compared with the conventional meniscectomy,it is more in line with the biological theory of human body.It can retain the basic structure and function of meniscus,which is conducive to postoperative recovery of patients and is worthy of clinical reference.
Objective To analyze clinical value of meniscectomy and meniscal forming suture under knee arthroscopy in discoid meniscus injury. Methods 46 patients with meniscus injury of knee joint who were admitted and treated in our wards of our hospital from July 2016 to February 2018 were selected in the study.The control group underwent meniscectomy and the experimental group underwent meniscal forming suture under knee arthroscopy.Clinical curative effects after treatment of patients in two groups were compared. Results The operation time in the experimental group was(58.1±7.3) min,significantly longer than that in the control group(50.5±4.7) min.Time for postoperative functional exercise in the experimental group was(27.2±6.8) days,significantly shorter than that in the control group(37.2±7.8) days.Excellent and good rate of curative effect in the experimental group was 91.30%,higher than that in the control group 73.91%.The difference was significant(P < 0.05).Before treatment,Lysholm score and knee joint IKDC score of the experimental group were respectively(61.2±7.6) and(53.4±6.5).After the followup for half a year,Lysholm score and knee joint IKDC score of the experimental group were respectively(87.5+8.1)and(83.7±9.3). Before treatment,Lysholm score and knee joint IKDC score of the control group were respectively(60.3±8.7) and(54.6±7.1).After the follow-up for half a year,Lysholm score and knee joint IKDC score of the control group were respectively(77.1±8.4) and(73.4±7.1).Differences in Lysholm score and knee joint IKDC score before treatment of patients in two groups had no statistical significance(P > 0.05).After the follow-up for half a year,Lysholm score and knee joint IKDC score were both significantly improved,while the scores in the experimental group were significantly higher than those in the control group.The difference was statistically significant(P < 0.05).Conclusion Application of meniscal forming suture under knee arthroscopy in meniscus injury has an accurate curative effect.Compared with the conventional meniscectomy,it is more in line with the biological theory of human body.It can retain the basic structure and function of meniscus,which is conducive to postoperative recovery of patients and is worthy of clinical reference.
引文
[1]李中正,王玉聪,方镇洙,等.外侧盘状半月板损伤关节镜下部分切除成形术与附加缝合术疗效比较[J].中国骨与关节损伤杂志,2015,30(10):1055-1057.
[2]杨健齐,魏鲁青,张健平,等.FAST-FIX全内缝合系统治疗膝关节半月板后角损伤中期疗效观察[J].广州医药,2017,48(1):32-35.
[3]谢杰,王双利,殷浩,等.关节镜半月板成形术治疗50岁以上膝关节半月板损伤患者的疗效分析[J].中华解剖与临床杂志,2015,20(4):335-338.
[4]徐青镭,李飞,韩国一,等.儿童外侧盘状半月板损伤的关节镜下中央成形加外周缝合治疗[J].中国骨与关节杂志,2015,4(4):248-251.
[5]白涛,王迎春,呼瑞,等.关节镜手术治疗膝关节半月板损伤的疗效及优点分析[J].西南国防医药,2018,28(2):165-167.
[6]郭瑞军.肌肉骨骼系统超声学[M].北京:人民军医出版社,2008:77.
[7]陈茂祯,李智.关节镜手术治疗膝关节半月板损伤的临床观察[J].黑龙江医药,2016,29(2):317-319.
[8]张洪鑫,于洪昌,宋波,等.膝关节镜下中心成形联合边缘稳定术治疗外侧盘状半月板损伤[J].中国骨与关节损伤杂志,2015,30(6):599-602.
[9]左坦坦.关节镜下半月板成形缝合术治疗盘状半月板损伤的临床观察[J].深圳中西医结合杂志,2018,28(4):123-125.
[8]宋山峰,李百华,王会如,等.关节镜下半月板成形缝合术对半月板损伤的疗效分析[J].河南医学研究,2018,27(7):1258-1259.
[10]钱雄,郑龙坡.关节镜下半月板切除术与成形缝合术治疗盘状半月板损伤的临床对比研究[J].创伤外科杂志,2017,19(7):539-541.
[11]唐进,吉明,廖乙名,等.盘状半月板损伤修复:关节镜下缝合成形结合玻璃酸钠注射[J].中国组织工程研究,2015,19(37):5943-5949.
[12]熊新为,李大成,胡裕桐,等.关节镜下半月板成形缝合术与半月板切除术对于膝关节半月板损伤的临床效果分析[J].浙江创伤外科,2017,22(6):1118-1119.
[13]王庆,黄华扬,张涛,等.关节镜下半月板成形缝合术治疗盘状半月板损伤的近期疗效研究[J].中华关节外科杂志(电子版),2015,9(3):319-323.
[14]陈兆波,赵凡.关节镜下两种手术方式治疗老年膝关节半月板损伤的疗效比较[J].中国实用医药,2017,12(24):66-67.
[15]曹伟.关节镜下两种手术方式治疗膝关节半月板损伤临床研究[J].陕西医学杂志,2018,47(4):445-447.
[16]阿米克,李永刚,韦继南,等.膝关节半月板损伤关节镜治疗的现状[J].东南大学学报(医学版),2015,34(5):844-847.
[2]杨健齐,魏鲁青,张健平,等.FAST-FIX全内缝合系统治疗膝关节半月板后角损伤中期疗效观察[J].广州医药,2017,48(1):32-35.
[3]谢杰,王双利,殷浩,等.关节镜半月板成形术治疗50岁以上膝关节半月板损伤患者的疗效分析[J].中华解剖与临床杂志,2015,20(4):335-338.
[4]徐青镭,李飞,韩国一,等.儿童外侧盘状半月板损伤的关节镜下中央成形加外周缝合治疗[J].中国骨与关节杂志,2015,4(4):248-251.
[5]白涛,王迎春,呼瑞,等.关节镜手术治疗膝关节半月板损伤的疗效及优点分析[J].西南国防医药,2018,28(2):165-167.
[6]郭瑞军.肌肉骨骼系统超声学[M].北京:人民军医出版社,2008:77.
[7]陈茂祯,李智.关节镜手术治疗膝关节半月板损伤的临床观察[J].黑龙江医药,2016,29(2):317-319.
[8]张洪鑫,于洪昌,宋波,等.膝关节镜下中心成形联合边缘稳定术治疗外侧盘状半月板损伤[J].中国骨与关节损伤杂志,2015,30(6):599-602.
[9]左坦坦.关节镜下半月板成形缝合术治疗盘状半月板损伤的临床观察[J].深圳中西医结合杂志,2018,28(4):123-125.
[8]宋山峰,李百华,王会如,等.关节镜下半月板成形缝合术对半月板损伤的疗效分析[J].河南医学研究,2018,27(7):1258-1259.
[10]钱雄,郑龙坡.关节镜下半月板切除术与成形缝合术治疗盘状半月板损伤的临床对比研究[J].创伤外科杂志,2017,19(7):539-541.
[11]唐进,吉明,廖乙名,等.盘状半月板损伤修复:关节镜下缝合成形结合玻璃酸钠注射[J].中国组织工程研究,2015,19(37):5943-5949.
[12]熊新为,李大成,胡裕桐,等.关节镜下半月板成形缝合术与半月板切除术对于膝关节半月板损伤的临床效果分析[J].浙江创伤外科,2017,22(6):1118-1119.
[13]王庆,黄华扬,张涛,等.关节镜下半月板成形缝合术治疗盘状半月板损伤的近期疗效研究[J].中华关节外科杂志(电子版),2015,9(3):319-323.
[14]陈兆波,赵凡.关节镜下两种手术方式治疗老年膝关节半月板损伤的疗效比较[J].中国实用医药,2017,12(24):66-67.
[15]曹伟.关节镜下两种手术方式治疗膝关节半月板损伤临床研究[J].陕西医学杂志,2018,47(4):445-447.
[16]阿米克,李永刚,韦继南,等.膝关节半月板损伤关节镜治疗的现状[J].东南大学学报(医学版),2015,34(5):844-847.