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[1]袁祥生,周紅星.關節(jié)鏡下半月板成形縫合術與半月板部分切除術治療單純半月板撕裂傷的比較研究[J].中醫(yī)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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關節(jié)鏡下半月板成形縫合術與半月板部分切除術治療單純半月板撕裂傷的比較研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數:
2023年04期
頁碼:
12-16
欄目:
臨床研究
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; 周紅星
(中國人民解放軍聯勤保障部隊第九八九醫(yī)院,河南 平頂山 467000)
Author(s):
YUAN Xiangsheng; ZHOU Hongxing
The 989th Hospital of PLA Joint Logistics Support Force,Pingdingshan 467000,Henan,China
關鍵詞:
膝損傷;  半月板;  關節(jié)鏡檢查;  臨床試驗
Keywords:
knee injuries;  meniscus;  arthroscopy;  clinical trial
摘要:
目的:比較關節(jié)鏡下半月板成形縫合術與半月板部分切除術治療單純半月板撕裂傷的臨床療效和安全性。方法:回顧性分析320例單純半月板撕裂傷患者的病例資料,其中采用半月板成形縫合術治療160例(半月板成形縫合組),采用半月板部分切除術治療160例(半月板部分切除組)。比較2組患者的手術時間、膝關節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評分、美國膝關節(jié)協會(American Knee Society,AKS)評分、術后3年內再手術情況、術后膝關節(jié)彈響殘留情況及并發(fā)癥發(fā)生情況。結果:①手術時間。半月板成形縫合組患者手術時間長于半月板部分切除組[(75.13±2.71)min,(51.28±1.59)min,t=3.946,P=0.008]。②膝關節(jié)疼痛VAS評分。術前及術后1個月、6個月、1年、3年,2組患者膝關節(jié)疼痛VAS評分隨時間均呈下降趨勢,且2組的下降趨勢完全一致[(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評分。術前及術后1個月、6個月、1年、3年,2組患者AKS評分隨時間均呈上升趨勢,且2組的上升趨勢完全一致[(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再手術率。術后3年內半月板成形縫合組3例、半月板部分切除組12例半月板再次撕裂; 半月板成形縫合組術后3年內再手術率低于半月板部分切除組(χ2=5.666,P=0.017)。⑤術后殘留膝關節(jié)彈響率。半月板成形縫合組2例、半月板部分切除組17例術后殘留膝關節(jié)彈響,半月板成形縫合組術后殘留膝關節(jié)彈響率低于半月板部分切除組(χ2=12.590,P=0.000)。⑥并發(fā)癥。2組患者術后均無感染、下肢深靜脈血栓形成等并發(fā)癥發(fā)生。結論:對于單純半月板撕裂傷,關節(jié)鏡下半月板成形縫合術與半月板部分切除術在緩解膝關節(jié)疼痛、恢復膝關節(jié)功能和安全性方面相當,雖然前者的手術時間長,但能明顯降低術后3年再手術率和術后殘留膝關節(jié)彈響率。
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 本文編輯:時紅磊)

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更新日期/Last Update: 1900-01-01