关节镜下盘状半月板损伤的治疗

目的 探讨膝关节镜下盘状半月板损伤手术治疗的最佳方法和疗效.方法 2011年11月至2013年4月,41例盘状半月板损伤患者行关节镜下半月板成形手术,其中38例患者采用Fast-Fix半月板缝合钉行半月板缝合.术后1个月内卧床进行关节功能锻炼,1个月后开始下地不完全负重功能锻炼,3个月后完全负重功能锻炼.结果 手术全部成功,无术后并发症.术后41例全部获得随访,随访时间3.0～18.0个月,平均10.5个月.术前Lysholm评分为（68.28 ±8.04）分,术后3个月为（88.17±7.49）分,两者比较差异有统计学意义（t=11.59,P＜0.05）.临床疗效：优28例,良10例,一般3例,差0例,优良率92.7％ （38/41）.结论 膝关节镜下盘状半月板成形缝合术治疗盘状半月板损伤具有手术创伤小、半月板结构正常及功能保留完整、康复快、并发症少的优点.目前关节镜下成形缝合术是治疗盘状半月板损伤的最好方法.

Treatment of discoid meniscus injury by arthroscopic surgery

Objective To investigate the bettertherapeutic method and clinical efficacy of discoid meniscus injury under arthroscope.Methods Forty-one patients with discoid meniscus injury were selected as our subjects from Nov.2011 to Feb.2013,who were treated by arthroscopic surgery and performed with meniscus plasty.Thirt-eight patients were received ultra Fast-fix meniscal repair system.Joint function exercises were performed on bed within 1 month after operation.Incomplete weight bearing were performed after 1 month postoperation.After 3 month postoperation,they were permitted for full weight bearing.Results All patients were treated successfully with surgery and no postoperative complications occurred.The patients were followed up from 3.0 to 18.0 months and average was 10.5 months.The preoperative Lysholm scores were（68.28 ±8.04）） lower than that at the postoperation （88.17 ± 7.49）） and the difference were significant （t =11.59,P ＜ 0.05）.Furthermore,according to Ikeuchi criterion,the outcomes were 28 cases with excellent,10 cases with good and 3 cases with general rank.Conclusion Discoid meniscus plasty and suture under arthroscope is proved to be a better approach with less trauma,recovery quickly and fewer complications.It should be a preferred method for discoid meniscus injury.