关节镜手术治疗青年前交叉韧带合并半月板损伤的短期预后分析

目的]分析关节镜手术对青年前交叉韧带(Anterior cruciate ligament,ACL)合并半月板损伤患者短期预后的影响,探讨其临床应用价值.方法]选取本院2014年5月至2016年5月收治的129例ACL合并半月板损伤的青年患者,均实施关节镜手术治疗;观察不同O'annr FLF分类患者术前、术后3个月国际膝部文件委员会(IKDC)主观膝部评分及Lysholm膝关节评分变化,并比较不同分类半月板损伤患者临床疗效的差异,总结其短期预后.结果]129例患者手术均顺利实施,无中转开放手术者,术后恢复良好,切口均Ⅰ期愈合,未见严重并发症发生,均获得有效随访.不同O'annr FLF分类患者术后3个月IKDC评分、Lysholm评分均较术前升高,差异有统计学意义(P＜0.05).患者术后3个月膝关节活动均恢复正常范围,未见疼痛、肿胀、交锁症状,O'annrFLF分类为纵裂者,其临床优良率高于其他分类,差异有统计学意义(P＜0.05).结论]关节镜手术治疗不同分类ACL合并半月板损伤均可取得较好的短期预后,且不会导致严重并发症发生,具有确切的近期疗效与安全性.

Short-term Prognosis of Anterior Cruciate Ligament Combined with Meniscus Injury Treated by Arthroscopic Surgery

Objective]To analyze short-term prognosis of arthroscopic surgery for the treatment of anterior cruciate ligament (ACL) combined with meniscus injury in youth and to explore its clinical application value.Methods]A total of 129 cases of youth with ACL and meniscus injury from May 2014 to May 2016 were collected for the study.Patients were classified according to O'annr FLF and were all treated by arthroscopic surgery.Subjective evaluation of knee scores based on the criteria of international knee document committee council (IKDC) and Lysholm were recorded at preoperation and at 3 months postoperation.Clinical efficacy and short-term prognosis among patients with different meniscus injuries were compared and statistically analyzed.Results]Arthroscopy was successfully implemented on all 129 patients (open surgery was not necessary),and the postoperative recovery was good (phase Ⅰ healing of incision) at the 3-month follow up.No serious complications occurred.The scores of both IKDC and Lysholm among patients with different O'annr FLF classifications were higher at 3-moth postoperation than those at preoperation;the differences were statistically significant (P ＜0.05).The patients' knee activities restored to normal within 3 months after surgery without pain,swelling or joint lock symptoms.Patients with longitudinal crack knees according to O'annr FLF classification had better results compared to those of other classifications,and the difference was statistically significant (P ＜0.05).Conclusion]Arthroscopic surgery on different classifications of ACL combined with meniscus injury can achieve very good short-term prognosis without serious complications.It is a safe and effective way to treat ACL with meniscus injury in youth.