关节镜下部分切除内侧和外侧半月板的近期疗效比较

目的 比较关节镜下半月板部分切除术治疗内外侧半月板损伤的近期疗效. 方法 2003年1月-2006年1月,207 例膝关节稳定的半月板损伤患者(无合并关节内韧带损伤)于关节镜下行半月板部分切除术.其中内侧半月板部分切除术(内侧组)115例,男50例,女65例;年龄14～78岁,平均46.9岁.左侧66例,右侧49例.其中26例外伤至手术时间 6 d～6个月,平均2.1个月.外侧半月板部分切除术(外侧组)92例,男18例,女74例;年龄16～62岁,平均41.1 岁.左侧57例,右侧35例.其中24例外伤至手术时间9 d～6个月,平均1.9个月.Lysholm膝关节评分系统评价治疗效果并作手术前后及组间比较. 结果 术后患者创口均Ⅰ期愈合,无感染、关节僵硬及软组织坏死等并发症.全部获随访 12～45 个月,平均 31.5 个月.内侧组及外侧组 Lysholm 评分从术前 (61.3±16.9) 和 (57.4±17.6) 分提高至随访时(95.0±7.9) 和 (93.3±7.4) 分,差异均有统计学意义(P<0.01);两组间手术前后的 Lysholm 评分比较差异无统计学意义(P>0.05).内侧组膝关节功能优107例,良5例,中3例,优良率为 97.39%;外侧组优80例,良12例,优良率为100%. 结论 关节镜下部分切除术治疗半月板损伤是一种安全有效的方法,而部分切除术的近期治疗效果无差异.

A COMPARATIVE STUDY ON SHORT-TERM EFFECTS OF ARTHROSCOPIC PARTIAL MENISCECTOMY IN TREATING MEDIAL VERSUS LATERAL MENISCUS INJURIES

OBJECTIVE: To compare the short-term effects of arthroscopic partial meniscectomy in treating medial versus lateral meniscus injuries. METHODS: From January 2003 to January 2006,207 patients with meniscus injury (without intraarticular ligament injury) underwent arthroscopic partial meniscectomy. The medial meniscus injury group included 115 cases, 50 males and 65 females; aged 14 to 78 years (mean 46.9 years); 66 left knees and 49 right knees. Twenty-six cases had injury histories, the delayed time from injury to surgery ranged from 6 d to 6 months (mean 2.1 months). The lateral meniscus injury group included 92 cases,18 males and 74 females; aged 16 to 62 years (mean 41.1 years); 57 left knees and 35 right knees. Twenty-four cases had injury histories,the delayed time from injury to surgery ranged from 9 d to 6 months (mean 1.9 months). Lysholm score system was applied and the scors of pre- and post-operation and were compared between two groups. RESULTS: The period of follow-up ranged from 12 to 45 months (mean 31.5 months). In medial meniscus injury group and lateral meniscus injury group, the Lysholm score increased from 61.3+/-16.9 and 57.4+/-17.6 preoperation to 95.0+/-7.9 and 93.3+/-7.4 postoperation respectively. There was statistically significant difference between preoperation and postoperation (P<0.01), and there was no statistically significant difference between two groups (P>0.05). The excellent and good rates for function of knee joint were 97.39% (excellent in 107 cases, good in 5 cases and fair in 3 cases) in medial meniscus injury group and 100% (excellent in 80 cases and good in 12 cases) in lateral meniscus injury group. CONCLUSION: Arthroscopic partial meniscectomy is a safe and effective treatment for meniscus injury, there is no diference in short-term effects in treating medial versus lateral meniscus injuries.