半月板桶柄样撕裂与垂直撕裂缝合后短期临床疗效
摘要
目的比较由外向内联合fast-fix技术修复半月板桶柄样撕裂与由外向内技术修复无移位的垂直半月板撕裂的临床效果。方法对自2013-01—2015-01收治的半月板桶柄样撕裂或垂直撕裂患者44例,桶柄样撕裂组(23例)采用关节镜下由外向内联合fast-fix缝合处理;半月板垂直撕裂组(21例)采用关节镜下由外向内垂直缝合。结果桶柄样撕裂组获得平均29.4 (24～50)个月的随访;垂直撕裂组获得平均28.3 (28～47)个月的随访。术后2组WOMAC评分、Lysholm评分、Tegner评分较术前明显改善,差异有统计学意义(P <0.05)。2组间术后WOMAC评分(t=13.454,P=0.614)、Lysholm评分(t=11.237,P=0.311)、Tegner评分(t=19.632,P=0.891)及患者满意度(t=9.745,P=0.624)比较,差异无统计学意义(P>0.05)。结论采用由外向内及fast-fix技术修复半月板桶柄样撕裂与由外向内技术修复无移位的垂直半月板撕裂,均取得了良好的临床疗效和较低的失败率。
引文
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[2]Lysholm J,Gillquist J.Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale[J].Am J Sports Med,1982,10(3):150-154.
[3]Bellamy N,Buchanan WW,Goldsmith CH,et al.Validation study of WOMAC:a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee[J].J Rheumatol,1988,15(12):1833-1840.
[4]Tengrootenhuysen M,Meermans G,Pittoors K,et al.Long-term outcome after meniscal repair[J].Knee Surg Sports Traumatol Arthrosc,2011,19(2):236-241.
[5]Popescu D,Sastre S,Caballero M,et al.Meniscal repair using the fast-fix device in patients with chronic meniscal lesions[J].Knee Surg Sports Traumatol Arthrosc,2010,18(4):546-550.
[6]Espejo-Reina A,Serrano-Fernandez JM,Martin-Castilla B,et al.Outcomes after repair of chronic bucket-handle tears of medial meniscus[J].Arthroscopy,2014,30(4):492-496.
[7]王刚涛,张卫东,张旭辉,等.关节镜下修复外侧半月板体部完全撕裂疗效观察[J].中国骨与关节损伤杂志,2017,32(12):1304-1305.
[8]陈铁柱,李晓声,陈宏文,等.关节镜下Fast-fix缝合半月板损伤132例中期疗效观察[J].中国骨与关节损伤杂志,2014,29(6):607-608.
[9]李明,刘华,章云峰,等.盘状半月板切除术对中老年患者下肢力线的早期影响[J].中国骨与关节损伤杂志,2018,33(6):575-578.
[10]Wasserstein D,Dwyer T,Gandhi R,et al.A matched-cohort population study of reoperation after meniscal repair with and without concomitant anterior cruciate ligament reconstruction[J].Am JSports Med,2013,41(2):349-355.
[11]Schillhammer CK,Werner FW,Scuderi MG,et al.Repair of lateral meniscus posterior horn detachment lesions:a biomechanical evaluation[J].Am J Sports Med,2012,40(11):2604-2609.
[12]Dean CS,Chahla J,Matheny LM,et al.Outcomes after biologically augmented isolated meniscal repair with marrow venting are comparable with those after meniscal repair with concomitant anterior cruciate ligament reconstruction[J].Am J Sports Med,2017,45(6):1341-1348.