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盘状外侧半月板广泛水平撕裂的单叶部分半月板切除术:半月板外周厚度减小会影响手术效果吗?(平均四年随访)

Single-leaf partial meniscectomy in extensive horizontal tears of the discoid lateral meniscus: Does decreased peripheral meniscal thickness affect outcomes? (Mean four-year follow-up).

作者信息

Lee Se-Won, Chun Yong-Min, Choi Chong-Hyuk, Kim Sung-Jae, Jung Min, Han Joon-Woo, Kim Sung-Hwan

机构信息

Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Daejeon 34943, Republic of Korea.

Department of Orthopedic Surgery, Severance Hospital, Arthroscopy and Joint Research Institute, Yonsei University, College of Medicine, Seoul 03722, Republic of Korea.

出版信息

Knee. 2016 Jun;23(3):472-7. doi: 10.1016/j.knee.2015.11.019. Epub 2016 Feb 12.

DOI:10.1016/j.knee.2015.11.019
PMID:26875744
Abstract

BACKGROUND

To evaluate whether single-leaf partial meniscectomy in horizontal tears along the entire discoid lateral meniscus has any advantages in clinical and radiological results compared with other meniscectomies in discoid lateral meniscus.

METHODS

A total of 145 patients with a horizontal tear pattern in symptomatic lateral discoid meniscus were retrospectively reviewed. Twenty-seven patients had undergone full-extent single-leaf partial meniscectomy (group A), 60 had undergone conventional partial meniscectomy (saucerization) maintaining peripheral meniscal height (group B), and 58 patients had undergone total meniscectomy (group C). Each patient was evaluated with the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective grading, and modified Kellgren-Lawrence grade in plain radiography at their last follow-up.

RESULTS

Group C had inferior functional results to groups A and B on the Lysholm knee score and IKDC subjective score. There was no significant difference between groups A and B. Group C fared significantly worse than groups A and B (p=0.003, p<0.001) by modified Kellgren-Lawrence grade.

CONCLUSION

With regard to clinical and radiological evaluations in lateral discoid meniscus tears, the full-extent single-leaf partial meniscectomy group had no adverse results compared with the total meniscectomy group and was not significantly different compared to the conventional partial meniscectomy group.

STUDY DESIGN

Cohort study.

LEVEL OF EVIDENCE

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

摘要

背景

评估沿整个盘状外侧半月板水平撕裂进行单叶部分半月板切除术与盘状外侧半月板的其他半月板切除术相比,在临床和影像学结果方面是否具有任何优势。

方法

回顾性分析145例有症状的外侧盘状半月板水平撕裂患者。27例患者接受了全层单叶部分半月板切除术(A组),60例患者接受了保持半月板周边高度的传统部分半月板切除术(碟形化,B组),58例患者接受了全半月板切除术(C组)。在最后一次随访时,对每位患者进行Lysholm膝关节评分、国际膝关节文献委员会(IKDC)主观分级,并在X线平片上进行改良Kellgren-Lawrence分级评估。

结果

在Lysholm膝关节评分和IKDC主观评分方面,C组的功能结果低于A组和B组。A组和B组之间无显著差异。通过改良Kellgren-Lawrence分级,C组的情况明显比A组和B组差(p = 0.003,p < 0.001)。

结论

对于外侧盘状半月板撕裂的临床和影像学评估,全层单叶部分半月板切除术组与全半月板切除术组相比没有不良结果,与传统部分半月板切除术组相比也无显著差异。

研究设计

队列研究。

证据水平

III级,治疗性研究。有关证据水平的完整描述,请参阅作者指南。

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