[1]袁祥生,周红星.关节镜下半月板成形缝合术与半月板部分切除术治疗单纯半月板撕裂伤的比较研究[J].中医正骨,2023,35(04):12-16.
　YUAN Xiangsheng,ZHOU Hongxing.A comparative study of arthroscopic meniscal suture versus partial meniscectomy in the treatment of simple meniscal laceration[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(04):12-16.
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关节镜下半月板成形缝合术与半月板部分切除术治疗单纯半月板撕裂伤的比较研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年04期
页码:
12-16
栏目:
临床研究
出版日期:
2023-04-20

文章信息/Info

Title:
A comparative study of arthroscopic meniscal suture versus partial meniscectomy in the treatment of simple meniscal laceration
作者:
袁祥生; 周红星
(中国人民解放军联勤保障部队第九八九医院,河南 平顶山 467000)
Author(s):
YUAN Xiangsheng; ZHOU Hongxing
The 989th Hospital of PLA Joint Logistics Support Force,Pingdingshan 467000,Henan,China
关键词:
膝损伤;  半月板;  关节镜检查;  临床试验
Keywords:
knee injuries;  meniscus;  arthroscopy;  clinical trial
摘要:
目的:比较关节镜下半月板成形缝合术与半月板部分切除术治疗单纯半月板撕裂伤的临床疗效和安全性。方法:回顾性分析320例单纯半月板撕裂伤患者的病例资料,其中采用半月板成形缝合术治疗160例(半月板成形缝合组),采用半月板部分切除术治疗160例(半月板部分切除组)。比较2组患者的手术时间、膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国膝关节协会(American Knee Society,AKS)评分、术后3年内再手术情况、术后膝关节弹响残留情况及并发症发生情况。结果:①手术时间。半月板成形缝合组患者手术时间长于半月板部分切除组[(75.13±2.71)min,(51.28±1.59)min,t=3.946,P=0.008]。②膝关节疼痛VAS评分。术前及术后1个月、6个月、1年、3年,2组患者膝关节疼痛VAS评分随时间均呈下降趋势,且2组的下降趋势完全一致[(7.97±1.75)分,(6.08±1.39)分,(3.26±1.18)分,(1.59±1.02)分,(1.00±0.89)分,F=1.361,P=0.003;(8.01±0.78)分,(6.13±0.81)分,(3.47±1.21)分,(1.85±0.96)分,(1.14±0.41)分,F=7.742,P=0.000]。③AKS评分。术前及术后1个月、6个月、1年、3年,2组患者AKS评分随时间均呈上升趋势,且2组的上升趋势完全一致[(36.83±5.26)分,(53.85±6.37)分,(74.96±5.28)分,(88.94±4.74)分,(96.33±2.73)分,F=4.736,P=0.000;(35.54±4.64)分,(52.17±5.43)分,(73.48±5.61)分,(86.58±5.49)分,(94.84±4.83)分,F=9.428,P=0.000]。④再手术率。术后3年内半月板成形缝合组3例、半月板部分切除组12例半月板再次撕裂; 半月板成形缝合组术后3年内再手术率低于半月板部分切除组(χ2=5.666,P=0.017)。⑤术后残留膝关节弹响率。半月板成形缝合组2例、半月板部分切除组17例术后残留膝关节弹响,半月板成形缝合组术后残留膝关节弹响率低于半月板部分切除组(χ2=12.590,P=0.000)。⑥并发症。2组患者术后均无感染、下肢深静脉血栓形成等并发症发生。结论:对于单纯半月板撕裂伤,关节镜下半月板成形缝合术与半月板部分切除术在缓解膝关节疼痛、恢复膝关节功能和安全性方面相当,虽然前者的手术时间长,但能明显降低术后3年再手术率和术后残留膝关节弹响率。
Abstract:
Objective:To compare the clinical efficacy and safety of arthroscopic meniscal suture and partial meniscectomy in the treatment of simple meniscal laceration.Methods:The medical records of 320 patients with simple meniscal laceration were retrospectively analyzed,including 160 treated with meniscal suture(the meniscal suture group)and 160 treated with partial meniscectomy(the partial meniscectomy group).The operation time,knee pain visual analogue scale(VAS)scores,American Knee Society(AKS)scores,re-operation within 3 years after operation,postoperative residual knee joint clicking,and incidence of complications after operation were compared between the two groups.Results:①Operation time.The operation time of the meniscal suture group was longer than that of the partial meniscectomy group(75.13±2.71 vs 51.28±1.59 min,t=3.946,P=0.008).②Knee pain VAS score.The knee pain VAS scores of both groups showed a decreasing trend over time before operation,at 1 month,6 months,1 year,and 3 years after operation,and the decreasing trends of both groups were completely consistent(7.97±1.75,6.08±1.39,3.26±1.18,1.59±1.02,1.00±0.89 points,F=1.361,P=0.003;8.01±0.78,6.13±0.81,3.47±1.21,1.85±0.96,1.14±0.41 points,F=7.742,P=0.000).③AKS score.The AKS scores of both groups showed an increasing trend over time before operation,at 1 month,6 months,1 year,and 3 years after operation,and the increasing trends of both groups were completely consistent(36.83±5.26,53.85±6.37,74.96±5.28,88.94±4.74,96.33±2.73 points,F=4.736,P=0.000; 35.54±4.64,52.17±5.43,73.48±5.61,86.58±5.49,94.84±4.83 points,F=9.428,P=0.000).④Re-operation rate.Three patients in the meniscal suture group and 12 patients in the partial meniscectomy group had meniscal laceration again within 3 years after operation.The re-operation rate in the meniscal suture group was lower than that in the partial meniscectomy group(χ2=5.666,P=0.017).⑤Postoperative residual knee joint clicking rate.Two patients in the meniscal suture group and 17 patients in the partial meniscectomy group had postoperative residual knee joint clicking.The postoperative residual knee joint clicking rate in the meniscal suture group was lower than that in the partial meniscectomy group(χ2=12.590,P=0.000).⑥Complications.No complications such as infection and deep venous thrombosis of the lower limbs were observed after operation in both groups.Conclusion:For simple meniscal laceration,arthroscopic meniscal suture and partial meniscectomy are equivalent in relieving knee pain and restoring knee joint function,and safety.Although the operation time of arthroscopic meniscal suture is longer,it can significantly reduce the re-operation rate within 3 years after operation and reduce the postoperative residual knee joint clicking rate.

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(收稿日期:2022-04-08 本文编辑:时红磊)

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备注/Memo

备注/Memo:
通讯作者:周红星 E-mail:hongxingzhou67@163.com
更新日期/Last Update: 1900-01-01