Scheller G, Sobau C, Bülow J U
Department of Orthopaedic Surgery, Clinical Faculty of Mannheim, The University of Heidelberg, Mannheim, Germany.
Arthroscopy. 2001 Nov-Dec;17(9):946-52. doi: 10.1053/jars.2001.28952.
To determine the clinical, functional, and radiographic long-term results of patients who underwent arthroscopic partial lateral meniscectomy in an otherwise normal knee.
This was a retrospective case-control study.
Between 1982 and 1991, 107 arthroscopic partial lateral meniscectomies were performed; 75 of these patients had an isolated lateral meniscal tear and their data were evaluated using the Lysholm score and a questionnaire recording patients' subjective satisfaction. Radiographic analysis was performed according to the Jäger-Wirth classification and Fairbank changes.
All 75 patients were examined by questionnaire, 55 underwent physical examination, and 58 had radiographic analysis. The follow-up period ranged from 5 to 15 years. Excellent and good Lysholm score results decreased from 77% at maximal improvement to 66% at follow-up; 43% of patients maintained their level of maximal improvement, 78% showed one or more Fairbank changes at follow-up, and using the Jäger-Wirth score, 84% showed radiographic deterioration.
Although deterioration of functional and especially radiographic results occurred after arthroscopic partial lateral meniscectomy, the number of good results, even with mean follow-up of 12.3 years, is remarkable. There was a high percentage of radiographic changes in our study, but there is no significant correlation between them and subjective symptoms or between them and functional outcome. We believe that careful meniscectomy provides good results for a long period of time but, the longer the follow-up, the more radiographic changes have to be expected; when meniscal refixation is possible, it should be performed.
确定在膝关节其他方面正常的情况下接受关节镜下外侧半月板部分切除术患者的临床、功能和影像学长期结果。
这是一项回顾性病例对照研究。
1982年至1991年间,进行了107例关节镜下外侧半月板部分切除术;其中75例患者存在孤立的外侧半月板撕裂,使用Lysholm评分和记录患者主观满意度的问卷对他们的数据进行评估。根据耶格-维尔特分类法和费尔班克改变进行影像学分析。
对所有75例患者进行了问卷调查,55例接受了体格检查,58例进行了影像学分析。随访期为5至15年。Lysholm评分优秀和良好的结果从最大改善时的77%降至随访时的66%;43%的患者维持了最大改善水平,78%的患者在随访时出现了一种或多种费尔班克改变,使用耶格-维尔特评分,84%的患者出现影像学恶化。
尽管关节镜下外侧半月板部分切除术后功能尤其是影像学结果出现恶化,但即使平均随访12.3年,良好结果的数量仍很可观。在我们的研究中,影像学改变的比例很高,但它们与主观症状之间或与功能结果之间均无显著相关性。我们认为,仔细的半月板切除术在很长一段时间内可提供良好的结果,但随访时间越长,预期的影像学改变就越多;当半月板可重新固定时,应进行该操作。