关节镜下全内缝合法修补半月板53例 的的疗效观察.docVIP

关节镜下全内缝合法修补半月板53例 的的疗效观察 　　【摘要】目的探讨关节镜下全内缝合法在半月板修补中的应用及临床疗效。方法对53例半月板损伤患者采用全内缝合法进行半月板修补。其中采用可吸收半月板箭5例, Fast-Fix全内半月板缝合系统48例。对患者进行术后6~12个月的随访, 随访时进行Lysholm评分、主观症状及查体检查。结果53例患者获得随访, Lysholm评分, 术前(47.26±14.58)分, 术后(90.31±17.63)分, 手术前后差异有统计学意义(t=-13.6993, P0.01)。患者临床表现：无交锁复发, 膝关节无疼痛, 无内侧与后外侧关节间隙压痛, 研磨挤压试验阴性。术后未见神经、血管或肌腱损伤的并发症, 未见感染病例。结论关节镜下全内缝合法是修补半月板损伤的理想方法, 其操作简单, 并发症少, 疗效确切, 治愈率高。 　　【关键词】关节镜；全内缝合法；半月板；修补 　　 　　Clinical observation on 53 cases of meniscus tears treated by srthroscopic all-inside suture technique DU Yu-kang, ZENG Zhuo-hui. People’s Hospital of Mei County, Meizhou 514031, China 　　【Abstract】Objective To investigate the application and clinical effect of arthroscopic al-inside suture technique for repairing tears of meniscus. Methods There were, 53 cases with meniscus tears were repaired by arthroscopic all-inside suture technique, 5 cases were fixed with bio-absorbable meniscus arrow. 48 cases were used Fast-Fix all-inside suture technique. Results All 53 patients were followed up, the follow-up time were 6~12 months after operation, meanwhile, Lysholm score, subjective symptoms and examination were recorded. Preoperative Lysholm scores were (47.26±14.58), whereas, postoperative ones were (90.31±17.63). There were significant differences between before and after operation(t=1.85, P0.01). No recurrent interlocking, no pains in joint medialis and post-medialis space. Grinding test was negative.The complications about injury of blood vessel, nerves and tendons were not found during 6~12 months follow-up. ConclusionArthroscopic all-inside suture technique is an ideal way to repair meniscus. The technology is simple to operate with fewer complications, high efficacy and cure rate. 　　【Key words】Arthroscopy; All-inside suture; Meniscus; Repair 　　膝关节内外侧半月板损伤在关节运动创伤中非常常见。以往研究及临床报道表明, 采用关节镜下半月板切除(含部分切除)术后近期效果满意、关节镜下操作相对简单, 是治疗半月板损伤的常用方法；但近年来许多相关临床研究报道, 从远期疗效来看, 半月板切除术后膝关节将不可避免地出现关节软骨退变, 并且半月板切除量与关节软骨退变程度呈正相关。目前, 通过关节镜下半月板修补术成为半月板损伤主要的治疗方式, 本院自2008年5月~2011年1