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半月板缝合术在 1 年随访时的临床和生物力学结果优于半月板切除术。

Meniscus suture provides better clinical and biomechanical results at 1-year follow-up than meniscectomy.

机构信息

Department of Pathophysiology of Locomotor Organs, Wiktor Dega Clinical Orthopaedic and Rehabilitation Hospital, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.

出版信息

Arch Orthop Trauma Surg. 2013 Apr;133(4):541-9. doi: 10.1007/s00402-013-1681-1. Epub 2013 Jan 31.

Abstract

BACKGROUND

Surgery of meniscus tear results in limitation of function. The aim of study was functional assessment of knee 1 year after surgery with two techniques in cases of the medial meniscus tear followed by the same supervised rehabilitation.

MATERIALS AND METHODS

A total of 30 patients with good KOSS scores constituted two equal groups after partial meniscectomy or meniscus suture. Measurements of knee extensors and flexors muscles peak torques were performed with angular velocities 60, 180, 240 and 300 s(-1) using Biodex IV system. One-leg-hop and one-leg-rising tests ascertained the function of operated knee. Results of examinations were compared with reference to healthy volunteers. Results of biomechanical and clinical studies were correlated to create complex and objective method evaluating treatment.

RESULTS

Extensors peak torque values at 60 s(-1) angular velocity and H/Q coefficient were decreased after meniscectomy more than meniscus suture in comparison to healthy volunteers (P ≤ 0.001; P ≤ 0.05). Analysis of functional tests revealed that patients after meniscectomy showed difference between operated and non-operated knee (P ≤ 0.01) while patients with meniscus suture differed the least to controls (P ≤ 0.05). Extensors peak torque values at 60 s(-1) angular velocity correlated with results of one-leg-rising test.

CONCLUSION

Results suggest worse functional effects when meniscectomy is applied which implies modification of the rehabilitative methods in a postoperative period.

摘要

背景

半月板撕裂手术后会导致功能受限。本研究的目的是在相同的监督康复治疗下,对内侧半月板撕裂患者采用两种不同手术技术治疗 1 年后膝关节的功能进行评估。

材料和方法

在部分半月板切除术或半月板缝合术后,根据 KOSS 评分,将 30 例评分良好的患者分为两组,每组 15 例。采用 Biodex IV 系统,以 60、180、240 和 300 s(-1) 的角速度测量膝关节伸肌和屈肌峰值扭矩。单腿跳跃和单腿站立测试确定了手术膝关节的功能。将检查结果与健康志愿者进行比较。对生物力学和临床研究的结果进行相关性分析,以创建一种复杂而客观的方法来评估治疗效果。

结果

与健康志愿者相比,半月板切除术组在 60 s(-1)角速度时的伸肌峰值扭矩值和 H/Q 系数下降更为明显(P≤0.001;P≤0.05)。功能测试分析显示,半月板切除术组患者的手术侧膝关节与非手术侧膝关节之间存在差异(P≤0.01),而半月板缝合术组患者与对照组之间的差异最小(P≤0.05)。60 s(-1)角速度时的伸肌峰值扭矩值与单腿站立测试结果相关。

结论

结果表明,半月板切除术的应用会产生更差的功能效果,这意味着术后康复方法需要进行修改。

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