Bin Seong-Il, Kim Jong-Min, Shin Seung-Jun
Department of Orthopaedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea.
Arthroscopy. 2004 Apr;20(4):373-8. doi: 10.1016/j.arthro.2004.01.004.
The purpose of this study was to introduce clinical features and characteristics of radial tears of the posterior horn of the medial meniscus and the results of arthroscopic surgery.
Retrospective case series.
From August 1996 to December 1999, 345 consecutive cases of medial meniscal tears were treated using arthroscopic surgery in Asan Medical Center, Seoul, Korea. Of these, 96 cases (27.8%) with radial tears of the posterior horn of the medial meniscus were reviewed. All patients were treated with arthroscopic partial meniscectomy. Based on medical records, including surgical notes and detailed arthroscopic photographs, we reviewed the age distribution of the patients, preoperative physical signs, magnetic resonance imaging, surgical findings, and clinical results using the Lysholm Knee Scoring scale and our own questionnaire.
Radial tears of the posterior horn of the medial meniscus were more common than previously known and also were more common in elderly patients. Most patients presented mechanical symptoms. Magnetic resonance imaging often failed to reveal the tears. Careful attention to the nature of pain and the physical examination was critical in making a diagnosis. Although most patients were elderly and had degenerated articular cartilages, subjective symptoms improved significantly after arthroscopic partial meniscectomy.
Radial tears of the medial meniscus posterior horn are common. Diagnosis of this tear is often difficult because most patients have osteoarthritic knees masking meniscal tears and magnetic resonance imaging shows unacceptably high rates of false-negative results. Following strict surgical indications, arthroscopic partial meniscectomy can help patients with low morbidity.
Level IV therapeutic study (case series, no or historical control group).
本研究旨在介绍内侧半月板后角放射状撕裂的临床特征及关节镜手术结果。
回顾性病例系列研究。
1996年8月至1999年12月，韩国首尔峨山医疗中心对345例连续的内侧半月板撕裂患者进行了关节镜手术治疗。其中，对96例（27.8%）内侧半月板后角放射状撕裂患者进行了回顾性分析。所有患者均接受关节镜下半月板部分切除术。基于包括手术记录和详细关节镜照片在内的病历资料，我们使用Lysholm膝关节评分量表和自行设计的问卷，对患者的年龄分布、术前体征、磁共振成像、手术发现及临床结果进行了回顾性分析。
内侧半月板后角放射状撕裂比之前所知更为常见，在老年患者中也更为普遍。大多数患者表现为机械性症状。磁共振成像常常无法显示这些撕裂。仔细关注疼痛性质和体格检查对于做出诊断至关重要。尽管大多数患者为老年人且存在关节软骨退变，但关节镜下半月板部分切除术后主观症状有显著改善。
内侧半月板后角放射状撕裂较为常见。由于大多数患者患有骨关节炎膝关节掩盖了半月板撕裂，且磁共振成像显示假阴性结果的发生率高得令人无法接受，因此这种撕裂的诊断往往很困难。遵循严格的手术指征，关节镜下半月板部分切除术可使患者并发症发生率较低。
IV级治疗性研究（病例系列研究，无对照组或历史对照组）
