关节镜下膝盘状软骨损伤的治疗和探讨

目的　探讨膝盘状软骨损伤的临床特点,研究关节镜下盘状软骨的处理原则。方法　对2 4 8例行关节镜诊治的盘状软骨病例的临床资料进行分析,探讨其年龄、性别、运动损伤史的分布特点以及交锁、弹响症状的发生率分布。2 4 8例盘状软骨关节镜下手术中,2 2 5例行关节镜下部分切除+成形术,14例行次全切除术,9例行全切除术。结果　盘状软骨损伤患者的年龄分布,2 0岁以下组较其他组差异有显著意义(P <0 .0 5 ) ;男女之间发病率差异无显著意义(P >0 .0 5 ) ;运动损伤史在本研究中显示差异无显著意义(P >0 .0 5 ) ;有交锁组与无交锁组比较差异有非常显著意义(P <0 .0 1) ;有弹响组与无弹响组比较,差异有显著性意义(P <0 .0 5 )。结论　盘状软骨损伤年龄分布显示青少年患者较多,在男女之间发病率无明显差异,盘状软骨损伤患者可以没有明确的运动损伤史,盘状软骨损伤患者常有弹响症状,少见交锁症状。关节镜下盘状软骨部分切除+成形术近远期疗效好,主张尽可能施行关节镜下成形术治疗盘状软骨。

Arthroscopic Evaluation and Treatment of Discoid Meniscus

Objective To study the clinical feature of discoid meniscus injuries and management for discoid meniscus. Methods According to the analysis of 248 cases discoid meniscus diagnosed by arthroscopy, a comparative analysis was made and the following topics were discussed: the distribution of the discoid meniscus in different age groups,different sex groups,with or without injuries,the signs of locking and non-locking,snapping and non-snapping.At arthroscopy, 239 torn discoid meniscuses were modified to normal semilunar shap,9 were totally resected. Results There is significant difference in the distribution of the complete type discoid meniscus (164 cases) between 20 and over 20-years of age (P<0.05),between the signs of locking and non-locking (P<0.01),between snapping and non-snapping (P<0.05). The analysis according to the patients with different sex and with or without injuries showed similar distributions among all cases (P>0.05). Conclusion The discoid meniscus injury is mostly seen in cases below 20 years of age. Snapping sign is in discoid meniscus injuries and rarely in cases with the locking sign. There is similar distribution among groups of patients with different sex and with or without injuries. Arthroscopic reshaping for discoid meniscus can obtain excellent ang good efficacy, we recommend that patients with discoid meniscus should be treated by reshaping.