囊肿切除联合撕裂半月板缝合术治疗半月板囊肿的临床研究_临床医学论文.docVIP

囊肿切除联合撕裂半月板缝合术治疗半月板囊肿的临床研究_临床医学论文 囊肿切除联合撕裂半月板缝合术治疗半月板囊肿的临床研究_临床医学论文 作者：王飞　陈百成　张建兵　闫昌葆　刘虎　王军 【摘要】 ［目的］探讨关节镜下半月板囊肿切除后联合半月板撕裂全关节内缝合技术的临床应用特点。［方法］2006年8月～2008年5月共收集19例外侧半月板囊肿病例，其中男7例，女12例，通过MRI检查：其中半月板撕裂合并半月板囊肿14例，单纯滑膜囊肿5例，最终关节镜下诊断半月板撕裂合并半月板囊肿15例，单纯滑膜囊肿4例，通过关节镜将囊肿切除后，利用肩关节镜缝合器械将损伤的半月板缝合，继而进行有效的康复计划。然后应用Lysholm评分系统对术前术后的关节功能进行比较。［结果］平均随访20.5个月，所有病例恢复了正常的运动，没有发现关节内或关节外的术后并发症的产生。Lysholm scores 术前平均（64±5）分,术后平均（94±3）分。应用Studeng-t检验术前和术后的关节功能评分有显著的差异(P＜0.001)。其中13例镜下随访发现11例完全愈合，2例不完全愈合。［结论］关节镜下半月板囊肿切除后联合半月板撕裂全关节内缝合技术（all-inside）无论在操作方面还是半月板的愈合方面都是一种简单有效的方法，是关节镜技术的一项创新和发展。 【关键词】 半月板囊肿　关节镜　膝 　　Abstract: ［Objective］To investigate all-inside techniques for repairing lateral meniscus anterior horn tear with cysts. ［Methods］Nineteen patiants with lateral meniscus anterior horn tear with cysts were collected from August 2006 to May 2008 with 7 males and 12 females. Five cases of isolated memberane cysts and 14 of lateral meniscus anterior horn tear with cysts were analyzed by MRI. Fifteen cases of lateral meniscus anterior horn tear with cysts and 4 of isolated memberanes cysts were finally diagnozed by arthoscopy.The apparatus of shoulder arthoscopy to sutured lateral injuried meniscus anterior horn were used after sheared cysts. Lysholm scores before and after operation were compared. Re-arthoscopy evaluation was performed for 13 patients.［Results］No case had complication after operation during short-term follow-up. Preoperative Lysholm scores was （64±5） points, postoperative scores was （94±7） ponits. Lysholm scores had significance between preoperation and postoperation (P＜0.01). Re-arthoscopy evaluation showed that 11 cases healed, and 2 cases incompletely healed.［Conclusion］All-inside techniques for repairing lateral meniscus anterior horn tear with cysts is an easy and effective methods. 　 Key words：meniscal cysts； arthroscopy； knee 　　半月板囊肿的常用治疗方法是切开或关节镜下单纯囊肿切除、半月板全切及半月板撕裂部分及囊肿切除，但是由于半月板在关节内的重要作用，保留完整的半月板组织具有重要的临床意义。单纯半月板囊肿切除后在半月板滑膜缘与半月板胫骨韧带之间往往出现较大的缺损，如不进行有效的处理，会导致半月板不稳