关节镜下可吸收半月板箭修复膝关节半月板损伤106例疗效观察

目的:观察总结关节镜下可吸收半月板箭修复损伤半月板的术后疗效及术后并发症。对象与方法:采用镜下可吸收半月板箭复位固定法,对106例患者的108个损伤半月板进行修复。通过症状、体征、Tegner和Lysholm评分对半月板缝合修复的临床效果及术后并发症进行了观察,对术后有明显症状、体征的患者进行了关节镜探查。结果:术后随访106例、1~9·5年(平均26±12·3个月)。Tegner评分术后(7·65±2·54)较术前(3·55±1·59)有显著性差异(P<0·001)。Lysholm评分术后(88·55±25·64)较术前(35·46±14·62)有显著性差异(P<0·001)。疗效优61只半月板,占56·5%;良35只半月板,占32·4%;可8只半月板,占7·4%;差4只半月板,占3·7%。总优良率为88·9%。对术后有症状和体征的14例患者进行关节镜再探查,发现4例未愈合,5例部分愈合。术后并发症包括半月板箭固定处的后关节囊刺痛5例。无严重的血管神经损伤,106例患者术后并发症总发生率4·72%。结论:关节镜下可吸收半月板箭修复半月板损伤手术成功率较高,术中和术后风险较小。

Clinical Outcome of 106 Patients with Meniscus Injuries Repaired by Arthroscopic Absorbable Meniscus Arrow

Objective To investigate the clinical outcome and post-operative complications of arthroscopic absorbable meniscus arrow repair for 108 menisci of 106 patients. Materials and Methods Among 106 patients, there were 85 males and 21 females, including 39 left knees, 65 right knees and 2 double knees. The average age of patients was 24±9.24 years. The average follow-up time of 106 patients was 26 ±12.3 months. The bio-absorbable meniscus arrow fixation was used for the meniscus repair. The clinical results of menisci repair was observed in accordance to symptoms, physical signs, Tegner scores and Lysholm scores. Post-operative complications were also observed. Re-arthroscopic exploration was performed for patients with obvious symptoms and physical signs during follow up time. Results Paired t-test showed that post-operative Tegner score (7.65±2.54) was significantly higher than that of pre-operative (3.55±1.59) (P<0.001). Pre-operative Lysholm score (35.46±14.62) was significantly lower than that of post-operative (88.55±25.64) (P<0.001). Results of meniscus repairing showed 61 excellent (56.50%), 35 good (32.44%), 8 satisfactory (7.4%), and 4 poor (3.7%). Total excellent and good result was 88.9%. For the 14 cases with obvious symptoms and physical signs, re-arthroscopy exploration found that there were 4 cases withont healing and 5 cases with partial healing. Post-operative complications included 5 cases with pain located at the meniscus arrow site in the posterior horns of the menisci. No serious blood vessels and nerves injury. Post-operative complication rate accounted for 4.72% in 106 cases. Conclusion Arthroscopic meniscus arrow repair of 108 menisci in 106 patients demonstrated a higher successful rate and less operative and post-operative risk.