膝关节外侧盘状半月板损伤的关节镜下手术治疗 ——附77例病例报告.DOCVIP

临床医学论文-膝关节外侧盘状半月板损伤的关节镜下手术治疗 ——附77例病例报告 【摘要】? 报告1组77例膝关节外侧盘状半月板损伤的关节镜下手术治疗与疗效。［方法］1999年1月～2005年6月，本院共完成77例膝关节外侧盘状半月板损伤的关节镜手术，手术采用常规髌下前内侧和前外侧入路，根据盘状半月板损伤情况进行半月板全切除术或成形术。其中21例(29.2%)患者行盘状半月板次全切除术和全切除术，13例(18.1%)患者行部分切除术，38例(52.8%)患者行半月板成形术。77例患者中，男39例(54.2%)，女33例(45.8%)，年龄8～51岁，平均(29.4±10.9)岁。有5例失访，72例患者随访时间12～44个月，平均(26.2±9.3)个月。手术前、后采用Lysholm评分对膝关节功能进行评定，并应用t检验进行统计学分析。［结果］所有病人术后膝关节疼痛及肿胀症状消失或明显减轻，活动度恢复正常。全部患者术后无感染、血管神经损伤、关节活动受限等手术并发症。手术前Lysholm评分为50～78分，平均(66.8±5.2)分，手术后提高至85～100分，平均(96.4±3.6)分。经过student-t检验分析，手术前后Lysholm评分有非常显著性差异(t=34.7，P0.01)。［结论］关节镜技术治疗膝关节外侧盘状半月板损伤创伤小、疗效佳，在保留半月板良好形态和生理功能，及减少患膝骨关节炎发生率方面有显著优点。 【关键词】? 盘状半月板 关节镜术 膝关节 ??? Abstract：［Objective］To report the treatment and outcome of treatment of discoid lateral meniscal tear by arthroscopic surgery.［Method］During the period between Jan.1999 and Jun.2005,77 patients suffered from discoid lateral meniscal tear have been treated by arthroscopic surgery in Xijing Hospital. The standard arthroscopic portals (anteromedial and anterolateral)were used.Lateral menisci were totally removed in the 21 patients (29.2%) of total 77 cases,whereas lateral menisci of 13 patients (18.1%) were removed partially and meniscus-plasty was applied in 38 patients (52.8%).Thirtynine (54.2%) of 77 patients were males,and 33 (45.8%) females.Their average age was 29.4±10.9 years (range 8～51 year).Five patients were lost in follow-up.The mean followup period of the rest 72 patients was 26.2 ±9.3 months (range 12～44 months).The patients were assessed preoperationally and post-operationally by the Lysholm score.Moreover,the results of Lysholm score were analyzed by studentt test.［Result］All patients had progress in pain,swelling,range of motion and knee function. No complication,which included intraarticular infection,iatrogenic injury,fibroarthritis or loss of range of motion,was found.Lysholm score was 66.8?.2 in average (range from 50 to 78) before operation,whereas it improved to 96.4?.6 in average (range from 85 to 100) afte