外侧半月板撕裂关节镜术中保留不同半月板层厚膝关节功能及骨性关节炎发生的影响

目的 探讨外侧半月板撕裂关节镜术中保留不同半月板层厚对膝关节功能及骨性关节炎发生的影响.方法 回顾性分析自2013-03-2015-01采用关节镜治疗的50例膝关节外侧半月板撕裂,19例未保留半月板层厚(未保留组),16例部分保留半月板层厚(部分保留组),15例完全保留半月板层厚(完全保留组).比较3组末次随访时膝关节功能Lysholm评分、疼痛VAS评分、Kellgren-Lawrence影像学分级.结果 50例均获得平均22.7(17～32)个月随访.末次随访时,3组Lysholm评分差异有统计学意义(P＜0.05),进一步两两比较,部分保留组、完全保留组Lysholm评分明显高于未保留组,而部分保留组与完全保留组Lysholm评分差异无统计学意义(P＞0.05).3组疼痛VAS评分、Kellgren-Lawrence影像学分级差异无统计学意义(P＞0.05).结论 外侧半月板撕裂关节镜术中保留不同半月板层厚者术后早期膝关节功能恢复更好,并且保留不同层厚半月板对早期膝关节骨性关节炎发生无明显影响.

Influence of different meniscus thickness preserved in arthroscopy of lateral meniscus tear on knee joint function and osteoarthritis

Objective To investigate the correlation between the knee joint function and osteoarthritis changes with the different meniscus thickness preserved in arthroscopy of lateral meniscus tear.Methods Fifty patients undergoing arthroscopic lateral meniscus tear surgery between Mar.2013 and Jan.2015 were retrospectively studied and allocated into three groups:19 cases without the thickness of the meniscus preserved(no preserved group),16 cases with partial thickness of meniscus preserved (partially preserved group) and 15 cases with the thickness of meniscus completely preserved(completely preserved group).The knee function,Lysholm score,VAS score and Kellgren-Lawrence imaging grade were compared between the 3 groups at the last follow-up.Results Fifty cases were followed up for an average of 22.7 (17-32)months.The three groups were statistically significant differences in Lysholm score at the end of the follow-up(P ＜0.05).The Lysholm score in the partial preserved group and the completely preserved group were significantly higher than that in the no preserved group (P ＜0.05),but there was no significant difference between the partially preserved group and the completely preserved group (P ＞0.05).Between the three groups there were no significant differences in VAS score and Kellgren-Lawrence imaging grade (P ＞0.05).Conclusion Different thickness of preserved meniscus in arthroscopic lateral meniscus tear showed good outcome in early stage and had no obvious effect on early osteoarthritis.