关节镜全内缝合法治疗外侧半月板腘肌腱裂孔处撕裂的临床疗效分析

Analysis of clinical efficacy of arthroscopic total internal suture in tearing of lateral meniscus diaphragmatic tendon

摘要:

目的 评估在半月板缝合器辅助下关节镜全内缝合法治疗膝关节外侧腘肌腱裂孔处半月板撕裂的临床疗效。方法 选择2018年1月－2019年6月该院确诊为腘肌腱处半月板撕裂并行关节镜下全内缝合的患者32例。患者年龄20～47岁，平均（33.75±8.21）岁；男21例，女11例；左膝损伤14例，右膝损伤18例。术前及术后6个月随访时，采用Lysholm膝关节评分、Tegner膝关节运动评分和美国膝关节协会评分（KSS）评估患者膝关节功能恢复情况；术前及术后6个月，采用视觉模拟评分（VAS）及关节活动度评估患者疼痛及关节活动度改善情况。结果 术后患者均得到6个月的随访，Lysholm评分由术前的（56.80±10.34）分提高至（89.56±5.71）分，Tegner评分由（2.47±0.78）分提高至（5.63±1.21）分，KSS由（42.28±4.75）分提高至（89.28±3.95）分，VAS由（5.03±1.77）分降至（1.85±0.54）分，关节活动度由（51.34±16.19）°扩大至（126.38±6.03）°，术前术后比较，差异均有统计学意义（P < 0.05）。结论 腘肌腱裂孔处半月板较松弛，采用缝合器辅助下关节镜全内缝合法，在缝合过程中将腘肌腱与半月板同时缝合，能够较大程度地改善患者术后临床症状，提高稳定性，加大关节活动度，值得临床推广应用。

Abstract:

Objective To evaluate the clinical efficacy of total internal suture assisted by arthroscopic meniscus suture in meniscus tear at the lateral diaphragmatic tendon fissure.Methods 32 patients with meniscal tear at the patellar tendon from January 2018 to June 2019 under arthroscopic total suture were selected. The patients were aged 20 ~ 47 years, with an average of (33.75 ± 8.21) years old; 21 males and 11 females; 14 left knee injuries and 18 right knee injuries. Postoperative knee function was assessed by the Lysholm score, Tegner score, and American Knee Society Score (KSS) at preoperative and 6-month follow-up; The visual analogue scale (VAS) and the range of joint activity span before and 6 mouths after surgery were used to evaluate the pain and improved joint mobility.Results All patients were followed up for 6 months. The Lysholm score of the patients before surgery increased from (56.80 ± 10.34) to (89.56 ± 5.71), the Tegner score increased from (2.47 ± 0.78) to (5.63 ± 1.21), and the KSS increased from (42.28 ± 4.75) to (89.28 ± 3.95), the VAS decreased from (5.03 ± 1.77) to (1.85 ± 0.54), and the range of joint mobility increased from (51.34 ± 16.19)° to (126.38 ± 6.03)°, there were statistically significant (P < 0.05).Conclusion The meniscus at the iliac tendon fissure is relatively loose, the total internal suture assisted by stapler is used, in the process of suturing, the popliteal tendon and meniscus are sutured at the same time, which can greatly improve the postoperative clinical symptoms, improve stability and increase joint mobility, worthy of clinical promotion and application.