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[1]張文橋,沈烈軍,陳文鋒.關(guān)節(jié)鏡下經(jīng)脛骨隧道帶袢鋼板固定與常規(guī)錨釘固定治療內(nèi)側(cè)半月板后根部撕裂的比較研究[J].中醫(yī)正骨,2021,33(11):24-30.
　ZHANG Wenqiao,SHEN Liejun,CHEN Wenfeng.A comparative study of arthroscopic Endobutton plate fixation through tibial tunnel versus conventional arthroscopic suture anchor fixation for treatment of medial meniscus posterior root tear[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(11):24-30.
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關(guān)節(jié)鏡下經(jīng)脛骨隧道帶袢鋼板固定與常規(guī)錨釘固定治療內(nèi)側(cè)半月板后根部撕裂的比較研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年11期
頁(yè)碼:
24-30
欄目:
臨床研究
出版日期:
2021-11-20

文章信息/Info

Title:
A comparative study of arthroscopic Endobutton plate fixation through tibial tunnel versus conventional arthroscopic suture anchor fixation for treatment of medial meniscus posterior root tear
作者:
張文橋; 沈烈軍; 陳文鋒
(舟山定海廣華醫(yī)院,浙江 舟山 316000)
Author(s):
ZHANG Wenqiao; SHEN Liejun; CHEN Wenfeng
Zhoushan Dinghai Guanghua Hospital,Zhoushan 316000,Zhejiang,China
關(guān)鍵詞:
膝損傷;  半月板;  關(guān)節(jié)鏡檢查;  縫合錨;  帶袢鋼板;  脛骨隧道;  臨床試驗(yàn)
Keywords:
knee injuries;  meniscus;  arthroscopy;  suture anchors;  endobutton plate;  tibial tunnel;  clinical trial
摘要:
目的:比較關(guān)節(jié)鏡下經(jīng)脛骨隧道帶袢鋼板固定與常規(guī)錨釘固定治療內(nèi)側(cè)半月板后根部撕裂的臨床療效及安全性。方法:將106例內(nèi)側(cè)半月板后根部撕裂患者隨機(jī)分為2組,每組53例,在關(guān)節(jié)鏡輔助下分別采用經(jīng)脛骨隧道帶袢鋼板固定(帶袢鋼板固定組)與常規(guī)錨釘固定(錨釘固定組)治療。記錄并比較2組患者的手術(shù)時(shí)間、術(shù)后下床時(shí)間、住院時(shí)間、膝關(guān)節(jié)主動(dòng)屈伸范圍、膝關(guān)節(jié)被動(dòng)屈伸范圍、膝關(guān)節(jié)文獻(xiàn)委員會(huì)(International Knee Documentation Committee,IKDC)評(píng)分、Tegner膝關(guān)節(jié)活動(dòng)水平評(píng)分、Lysholm膝關(guān)節(jié)評(píng)分及并發(fā)癥發(fā)生情況。結(jié)果:①一般指標(biāo)。2組患者的手術(shù)時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(110.52±18.64)min,(105.63±20.76)min,t=1.276,P=0.205]; 帶袢鋼板固定組患者的術(shù)后下床時(shí)間、住院時(shí)間均短于錨釘固定組[(24.35±6.87)h,(28.14±7.52)h,t=-2.709,P=0.008;(6.57±1.85)d,(7.76±1.94)d,t=-3.232,P=0.002]。②膝關(guān)節(jié)主動(dòng)屈伸范圍。術(shù)前2組患者膝關(guān)節(jié)主動(dòng)屈伸范圍比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(45.92°±7.21°,44.52°±7.02°,t=1.013,P=0.313); 術(shù)后1年,帶袢鋼板固定組患者的膝關(guān)節(jié)主動(dòng)屈伸范圍大于錨釘固定組(102.74°±10.64°,95.76°±9.56°,t=3.553,P=0.001),2組患者膝關(guān)節(jié)主動(dòng)屈伸范圍均較術(shù)前增大(t=33.564,P=0.000; t=27.790,P=0.000)。③膝關(guān)節(jié)被動(dòng)屈伸范圍。術(shù)前2組患者膝關(guān)節(jié)被動(dòng)屈伸范圍比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(50.21°±6.85°,50.55°±6.88°,t=-0.255,P=0.799); 術(shù)后1年,帶袢鋼板固定組患者的膝關(guān)節(jié)被動(dòng)屈伸范圍大于錨釘固定組(114.35°±11.58°,105.38°±10.25°,t=4.223,P=0.000),2組患者膝關(guān)節(jié)被動(dòng)屈伸范圍均較術(shù)前增大(t=36.116,P=0.000; t=32.268,P=0.000)。④IKDC評(píng)分。術(shù)前2組患者IKDC評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(31.58±4.29)分,(30.99±5.01)分,t=0.651,P=0.516]; 術(shù)后1年,帶袢鋼板固定組患者的IKDC評(píng)分高于錨釘固定組[(51.34±5.76)分,(45.76±7.52)分,t=4.289,P=0.000],2組患者IKDC評(píng)分均較術(shù)前增高(t=20.622,P=0.000; t=12.154,P=0.000)。⑤Tegner膝關(guān)節(jié)活動(dòng)水平評(píng)分。術(shù)前2組患者Tegner膝關(guān)節(jié)活動(dòng)水平評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(3.51±1.02)分,(3.42±1.05)分,t=0.448,P=0.655]; 術(shù)后1年,帶袢鋼板固定組患者的Tegner膝關(guān)節(jié)活動(dòng)水平評(píng)分高于錨釘固定組[(7.38±1.85)分,(6.14±1.65)分,t=3.642,P=0.000],2組患者Tegner膝關(guān)節(jié)活動(dòng)水平評(píng)分均較術(shù)前增高(t=13.778,P=0.000; t=11.976,P=0.000)。⑥Lysholm膝關(guān)節(jié)評(píng)分。術(shù)前2組患者Lysholm膝關(guān)節(jié)評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(50.92±7.05)分,(49.52±8.01)分,t=0.955,P=0.342]; 術(shù)后1年,帶袢鋼板固定組患者的Lysholm膝關(guān)節(jié)評(píng)分高于錨釘固定組[(85.64±7.38)分,(77.56±9.26)分,t=4.968,P=0.000],2組患者Lysholm膝關(guān)節(jié)評(píng)分均較術(shù)前增高(t=25.778,P=0.000; t=17.344,P=0.000)。⑦并發(fā)癥。帶袢鋼板固定組術(shù)后出現(xiàn)切口深部感染4例、切口未一期愈合2例,錨釘固定組術(shù)后出現(xiàn)切口深部感染6例、切口未一期愈合3例; 2組患者并發(fā)癥發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.699,P=0.403)。結(jié)論:關(guān)節(jié)鏡下經(jīng)脛骨隧道帶袢鋼板固定治療內(nèi)側(cè)半月板后根部撕裂,與常規(guī)錨釘固定治療相比,術(shù)后下床時(shí)間早、住院時(shí)間短、綜合療效好,膝關(guān)節(jié)屈伸范圍大、關(guān)節(jié)功能好,但兩者的手術(shù)時(shí)間及安全性相當(dāng)。
Abstract:
Objective:To compare the clinical curative effects and safety of arthroscopic Endobutton plate(EP)fixation through tibial tunnel versus conventional arthroscopic suture anchors(SA)fixation for treatment of medial meniscus posterior root tear(MMPRT).Methods:One hundred and six MMPRT patients were enrolled in the study and were randomly divided into 2 groups,53 cases in each group,and they were treated with arthroscopic EP fixation through tibial tunnel(EP fixation group)and conventional arthroscopic SA fixation(SA fixation group)respectively.The operative time,bed rest time,hospital stay,active knee flexion-extension range of motion(ROM),passive knee flexion-extension ROM,International Knee Documentation Committee(IKDC)score,knee Tegner Activity scale(TAS)score,Lysholm knee score(LKS)and complications were recorded and compared between the 2 groups.Results:①There was no statistical difference in operative time between the 2 groups(110.52±18.64 vs 105.63±20.76 minutes,t=1.276,P=0.205).The bed rest time and hospital stay were shorter in EP fixation group compared to SA fixation group(24.35±6.87 vs 28.14±7.52 hours,t=-2.709,P=0.008; 6.57±1.85 vs 7.76±1.94 days,t=-3.232,P=0.002).②There was no statistical difference in active knee flexion-extension ROM between the 2 groups before the surgery(45.92±7.21 vs 44.52 ±7.02 degrees,t=1.013,P=0.313)...

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備注/Memo

備注/Memo:
基金項(xiàng)目:舟山市衛(wèi)生健康委員會(huì)醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2020YB05)
通訊作者:張文橋 E-mail:[email protected]
更新日期/Last Update: 1900-01-01