Saragaglia D, Tourne Y, Effantin D, Leroy J M, Abu al Zahab M
Service de Chirurgie Orthopédique, CHU de Grenoble, Hôpital Sud.
Rev Chir Orthop Reparatrice Appar Mot. 1992;78(5):279-84.
A comparative retrospective study of 107 cases of arthroscopic meniscectomies performed between December 1985 and December 1988 on 52 operated patients under 45 (P1 = 54 knees) and 52 operated patients over 45 (P2 = 53 knees). Those two populations have been selected among 292 isolated meniscal lesions files (without anterior cruciate ligament tear) operated for arthroscopic meniscectomy between 1985 and 1988. There were 81 medial meniscus lesions, 16 lateral meniscus lesions and 10 bi-meniscal lesions. The follow-up was for 1 to 5 years with a score of 70.3 per cent functional satisfactory results for the above 45 years (P2) and a score of 89.4 per cent below 45 (P1). Regarding the medial meniscus lesions only, we count 76 per cent (P2) satisfactory results versus 87.5 per cent (P1). This assessment can be easily explained by the variety of meniscal lesions (8 degenerative meniscal lesions among P2 namely 15 per cent), by associated cartilage lesions of the medial compartment of the knee (medial condyle: P2 = 37.75 per cent, medial tibial plateau: P2 = 41.5 per cent) and by genu varum deformity. However, in spite of this significant statistical difference (alpha < 0.05), we don't think we should condemn the arthroscopic meniscectomy over 45: the morbidity is very low and if some patients were not cured, the majority of them said that they improved after the operation. The cartilaginous degenerations of the medial compartment, discovered during arthroscopy, in a context of genu varum, don't need any tibial osteotomy at first, especially if they are asymptomatic and without tibia varum.
对1985年12月至1988年12月期间接受关节镜半月板切除术的107例患者进行了一项对比回顾性研究，其中52例为45岁以下的手术患者（P1 = 54个膝关节），52例为45岁以上的手术患者（P2 = 53个膝关节）。这两组人群是从1985年至1988年因关节镜半月板切除术而手术的292例孤立半月板损伤病例（无前交叉韧带撕裂）中挑选出来的。其中有81例内侧半月板损伤、16例外侧半月板损伤和10例双侧半月板损伤。随访时间为1至5年，45岁以上组（P2）功能满意结果的比例为70.3%，45岁以下组（P1）为89.4%。仅就内侧半月板损伤而言，满意结果的比例在45岁以上组（P2）为76%，在45岁以下组（P1）为87.5%。这种评估结果很容易解释，原因包括半月板损伤的多样性（45岁以上组中有8例退行性半月板损伤，即15%）、膝关节内侧间室的相关软骨损伤（内侧髁：P2 = 37.75%，内侧胫骨平台：P2 = 41.5%）以及膝内翻畸形。然而，尽管存在这一显著的统计学差异（α < 0.05），我们认为不应谴责45岁以上患者的关节镜半月板切除术：其发病率非常低，如果有些患者没有治愈，大多数患者表示术后病情有所改善。在关节镜检查中发现的膝内翻情况下的膝关节内侧间室软骨退变，起初不需要任何胫骨截骨术，尤其是如果它们无症状且没有胫骨内翻。
