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关节镜下半月板由外向内技术修复的2至19年随访:一项回顾性研究。

Two to nineteen years follow-up of arthroscopic meniscal repair using the outside-in technique: a retrospective study.

作者信息

Abdelkafy Ashraf, Aigner Nicolas, Zada Mohamed, Elghoul Yassein, Abdelsadek Hesham, Landsiedl Franz

机构信息

Orthopaedic and Traumatology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Arch Orthop Trauma Surg. 2007 May;127(4):245-52. doi: 10.1007/s00402-006-0139-0. Epub 2006 Apr 12.

Abstract

PURPOSE

To perform a long-term follow-up evaluation of the outside-in technique of arthroscopic meniscal repair.

TYPE OF STUDY

Retrospective study.

METHODS

Between the years 1986 and 2002, 93 cases of arthroscopic meniscal repair using the outside-in technique have been operated by the senior author (F.L.). Forty-one patients were available for the follow-up evaluation with a mean follow-up of 11.71 years. The International Knee Documentation Committee (IKDC), the modified Lysholm score, the SF-36 (short form 36) health survey score, a visual analogue scale (VAS) for assessment of patients' satisfaction and another VAS for assessment of patients' pain were used retrospectively to evaluate the patients. We also used the Kellgren and Lawrence (K/L) classification of osteoarthritis to evaluate the preoperative X-rays and the X-rays done at the time of the follow-up evaluation. Failure was defined as having a meniscectomy procedure post-operatively.

RESULTS

From the 93 patients, 52 could not be retrieved for the follow-up evaluation, while 41 were available for it; 36 patients were clinically successful and 5 were considered as failure. Thirty-six patients were classified as grade "A" in the objective IKDC score, mean modified Lysholm score was 87.29 (SD 16.43), while mean SF-36 score was 85.73 (SD 14.17). The results of the VAS for operation satisfaction ranging from -10 to +10 revealed that the mean of the answers was 8.05 (SD 2.99). The results of the VAS for pain ranging from 0 to 10 revealed that the mean of the patients' pain at the time of the follow-up evaluation was 1.8 (SD 2.42). Twenty out of 24 (only 24 preoperative X-rays were available) were classified as having no osteoarthritis pre-operatively, whereas only 12 out of the 41 patients were classified as having no osteoarthritis (normal) at the time of the follow-up evaluation according to the K/L classification which indicates progression of osteoarthritis. No complications related to the outside-in arthroscopic meniscal repair procedure were reported.

CONCLUSION

We conclude that arthroscopic meniscal repair using the outside-in technique is a safe surgical procedure with a good clinical outcome.

摘要

目的

对关节镜下半月板修复的由外向内技术进行长期随访评估。

研究类型

回顾性研究。

方法

1986年至2002年间,资深作者(F.L.)对93例采用由外向内技术进行关节镜下半月板修复的病例实施了手术。41例患者可供随访评估,平均随访时间为11.71年。回顾性地使用国际膝关节文献委员会(IKDC)评分、改良Lysholm评分、SF-36(简短形式36)健康调查评分、用于评估患者满意度的视觉模拟量表(VAS)以及另一个用于评估患者疼痛的VAS对患者进行评估。我们还使用Kellgren和Lawrence(K/L)骨关节炎分类法来评估术前X线片以及随访评估时所拍摄的X线片。失败定义为术后进行了半月板切除术。

结果

93例患者中,52例无法找回进行随访评估,41例可供评估;36例临床成功,5例被视为失败。36例患者在客观IKDC评分中被归类为“A”级,改良Lysholm评分均值为87.29(标准差16.43),而SF-36评分均值为85.73(标准差14.17)。手术满意度VAS结果范围为-10至+10,显示答案均值为8.05(标准差2.99)。疼痛VAS结果范围为0至10,显示随访评估时患者疼痛均值为1.8(标准差2.42)。24例患者中(仅可得24份术前X线片),20例术前被归类为无骨关节炎,而根据K/L分类法,41例患者中随访评估时只有12例被归类为无骨关节炎(正常),这表明骨关节炎有所进展。未报告与由外向内关节镜下半月板修复手术相关的并发症。

结论

我们得出结论,采用由外向内技术进行关节镜下半月板修复是一种安全的手术方法,临床效果良好。

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