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盘状外侧半月板撕裂的治疗:34例膝关节的观察

Management of discoid lateral meniscus tears: observations in 34 knees.

作者信息

Atay O Ahmet, Doral M Nedim, Leblebicioğlu Gürsel, Tetik Onur, Aydingöz Ustün

机构信息

Department of Orthopaedics and Traumatology, Hacettepe University Medical Center, Ankara, Turkey.

出版信息

Arthroscopy. 2003 Apr;19(4):346-52. doi: 10.1053/jars.2003.50038.

Abstract

PURPOSE

The goal of this study was to evaluate arthroscopic partial resection of discoid lateral meniscus tears with an emphasis on radiographic evidence of degenerative changes after this procedure.

TYPE OF STUDY

Retrospective clinical study.

METHODS

Of 41 patients with an arthroscopic diagnosis of discoid meniscus over an 8-year period, 34 symptomatic lateral discoid meniscus tears in 33 patients were analyzed at an average follow-up of 5.6 years. The average age at operation was 19.8 years and most patients had vague and intermittent symptoms that caused delay in clinical diagnosis.

RESULTS

Eight patients were lost to follow-up and were excluded from the study. Magnetic resonance imaging, performed in 12 cases, and arthroscopy in all of these patients provided the precise diagnosis. All of the knees with symptomatic torn discoid menisci underwent arthroscopic partial meniscectomy. Only 1 Watanabe Wrisberg ligament type of discoid meniscus with posterior instability was totally meniscected. Based on Ikeuchi's grading, 39% of the knees had an excellent result, 46% had a good result, and 15% had a fair result; none of the results was poor.

CONCLUSIONS

At an average 5-year follow-up, partial meniscectomy in patients with a Watanabe complete or incomplete discoid meniscus showed 85% good or excellent clinical results. However, a significant percentage of patients show femoral condyle flattening on radiography.

摘要

目的

本研究的目的是评估关节镜下盘状外侧半月板撕裂的部分切除术,并重点关注该手术后退变改变的影像学证据。

研究类型

回顾性临床研究。

方法

在8年期间,对41例经关节镜诊断为盘状半月板的患者进行研究,分析了33例患者中34例有症状的外侧盘状半月板撕裂,平均随访时间为5.6年。手术时的平均年龄为19.8岁,大多数患者有模糊和间歇性症状,导致临床诊断延迟。

结果

8例患者失访,被排除在研究之外。12例患者进行了磁共振成像检查,所有这些患者均进行了关节镜检查以明确诊断。所有有症状的盘状半月板撕裂的膝关节均接受了关节镜下半月板部分切除术。只有1例具有后向不稳定的渡边Wrisberg韧带型盘状半月板被完全切除。根据池内分级,39%的膝关节结果为优,46%为良,15%为可;无结果为差的情况。

结论

平均5年随访时,渡边完全或不完全盘状半月板患者行半月板部分切除术,临床结果85%为良或优。然而,相当一部分患者在影像学上显示股骨髁扁平。

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