Chatain F, Robinson A H, Adeleine P, Chambat P, Neyret P
Department of Orthopaedics, H pital de la Croix Rousse, Caluire, France.
Knee Surg Sports Traumatol Arthrosc. 2001;9(1):15-8. doi: 10.1007/s001670000146.
We examined the natural history of arthroscopic medial meniscectomy in knees with an isolated meniscal injury by reviewing 317 of 894 cases following medial meniscectomy. At the time of the initial surgery none of the knees had been operated on, and there was no evidence of ligament injury. The patients were reviewed clinically and radiologically after a mean of 11.5 years (range 10-15). The knee was considered "normal" or "nearly normal" by 91% of patients. In 218 patients the contralateral knee was asymptomatic without history of operation or significant injury and could be used as control for comparison. Radiology showed 22.4% greater excess prevalence of joint space narrowing in the operated compared to the control knee. The factors predisposing to a poor radiological result were age above 35 years, the presence of medial compartment cartilage degeneration at the time of the first arthroscopy, resection of the posterior one-third of the meniscus, and meniscal rim resection. Preoperative participation in sport was a predictor of a better outcome.
我们通过回顾894例内侧半月板切除术患者中的317例，研究了孤立性半月板损伤膝关节关节镜下内侧半月板切除术的自然病史。初次手术时，所有膝关节均未接受过其他手术，且无韧带损伤证据。平均11.5年（10 - 15年）后对患者进行临床和影像学复查。91%的患者认为膝关节“正常”或“接近正常”。218例患者对侧膝关节无症状，无手术史或严重损伤史，可作为对照进行比较。影像学显示，与对照膝关节相比，手术侧膝关节间隙变窄的发生率高出22.4%。导致影像学结果不佳的因素包括年龄超过35岁、首次关节镜检查时内侧间室软骨退变、半月板后三分之一切除以及半月板边缘切除。术前参与运动是预后较好的一个预测因素。
