Li Jinglong, Lu Liangyu, Zhu Wenhui, Shi Dongliang, Zhan Ke, Wang Yubin
Department of Sports Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China.
Acta Orthop Traumatol Turc. 2014;48(3):276-82. doi: 10.3944/AOTT.2014.3167.
The aim of this study was to investigate the arthroscopic characteristics of meniscal injuries in osteoarthritic knees and explore their significance in the selection of surgical approach.
Four original types of meniscal injuries were defined. The study included 87 cases; 12 Type 1, 26 Type 2, 35 Type 3 and 14 in Type 4 meniscal injuries. For Type 1 injuries, 5 cases underwent meniscal suture repair and 7 cases partial meniscal resection. Partial meniscal resection was performed in 22 cases and subtotal resection in 4 cases of Type 2 injury. For Type 3 injury, meniscal debridement was performed in 2, partial resection in 8, subtotal resection in 19 and total resection in 6 cases. For Type 4 injury, 3 cases underwent subtotal resection and 11 underwent total resection. Patients were evaluated with the Lysholm, visual analog scale, and Kellgren-Lawrence scale scores and cartilage lesions stages.
Mean follow-up period was 26 (range: 8 to 51) months. Joint swelling or pain was present in 13 cases after fatigue. Twist lock symptom was observed in one Type 3 injury and one Type 4 injury. Joint flexion was limited to 20° in one Type 3 injury and two Type 4 injuries. Total knee joint replacement was performed in two Type 2 and two Type 4 injuries 2 to 3 years and 2 months after surgery.
The classification of meniscal injuries in osteoarthritic knees was designed to guide arthroscopic surgery and improve the therapeutic efficacy of minimally invasive surgery for knee osteoarthritis.
本研究旨在探讨骨关节炎膝关节半月板损伤的关节镜特征，并探讨其在手术方式选择中的意义。
定义了四种原始类型的半月板损伤。该研究纳入87例患者；12例为1型损伤，26例为2型损伤，35例为3型损伤，14例为4型半月板损伤。对于1型损伤，5例行半月板缝合修复，7例行部分半月板切除术。2型损伤中，22例行部分半月板切除术，4例行次全切除术。对于3型损伤，2例行半月板清理术，8例行部分切除术，19例行次全切除术，6例行全切除术。对于4型损伤，3例行次全切除术，11例行全切除术。采用Lysholm评分、视觉模拟评分和Kellgren-Lawrence评分以及软骨损伤分期对患者进行评估。
平均随访期为26个月（范围：8至51个月）。13例患者在疲劳后出现关节肿胀或疼痛。在1例3型损伤和1例4型损伤中观察到绞锁症状。1例3型损伤和2例4型损伤的关节屈曲受限至20°。2例2型损伤和2例4型损伤分别在术后2至3年和2个月行全膝关节置换术。
骨关节炎膝关节半月板损伤的分类旨在指导关节镜手术，提高膝关节骨关节炎微创手术的治疗效果。
