关节镜下清理并半月板切除治疗合并膝骨关节炎的半月板损伤

Arthroscopic debridement and meniscectomy in treatment of meniscus injury combined with osteoarthritis

摘要:

目的??探讨关节镜下清理并半月板切除治疗合并早、中期膝关节骨关节炎（KOA）的中、重度半月板损伤的疗效。方法?选取2011年10月-2014年10月该科156例合并有早、中期KOA的中、重度半月板损伤患者，行关节镜下清理并半月板切除术。术前对所有患者行Lysholm膝关节功能评分，常规行膝关节正侧位、髌骨轴位、双下肢全长站立位X片和患膝磁共振成像（MRI）检查，明确KOA诊断和临床分期以及半月板损伤诊断和分级。所有患者均在全麻下行关节镜下关节清理并半月板切除术。术后积极行患肢康复训练，术后7～10天出院，出院后佩戴护膝负重行走。采用门诊复诊或电话方式对患者进行随访。结果?所有患者均无围手术感染、化脓性关节炎等严重围手术期并发症；术后随访6～12个月，平均10.9个月。Lysholm膝关节功能评分术后（87.3±7.9）明显优于术前（67.5±4.9）（P <0.05）。结论?关节镜下清理并半月板切除治疗合并早、中期KOA的中、重度半月板损伤，创伤小、恢复快、近期疗效良好。

Abstract:

Objective?To investigate the effect of arthroscopic debridement and meniscectomy in treatment of moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage.?Methods?156 cases diagnosed with moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage were collected from October 2011 to October 2014. Lysholm knee score and preoperative examinations such as anteroposterior, lateral, axial radiographs, the standing full leg length X-ray film and MRI scan of the knee were recommended to definitively understand the osteoarthritis staging and meniscus injury grading. All patients were treated with arthroscopic debridement and meniscectomy. After operation, physical rehabilitation exercises and regular clinical follow-up were carried out as planned. The Lysholm knee score data from preoperation and terminal follow-up was statistical analyzed.?Results?No patient experienced any perioperative and postoperative complications. Statistical analysis showed that the Lysholm knee score of postoperation was significantly higher than that of preoperation [(87.3 ± 7.9) vs (67.5 ± 4.9), P < 0.05).?Conclusion?Arthroscopic debridement and meniscectomy in treatment of moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage, gains beneficial effects for its minimal invasion and quick recovery.