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关节镜下治疗盘状外侧半月板:长期随访结果

Arthroscopic treatment of the discoid lateral meniscus: results of long-term follow-up.

作者信息

Vandermeer R D, Cunningham F K

机构信息

University of Texas Southwestern Medical Center, Dallas.

出版信息

Arthroscopy. 1989;5(2):101-9. doi: 10.1016/0749-8063(89)90004-2.

DOI:10.1016/0749-8063(89)90004-2
PMID:2736005
Abstract

Twenty-two patients (25 knees) were evaluated at an average follow-up of 54 months for clinical results of arthroscopic treatment of the discoid lateral meniscus syndrome. Discoid lateral menisci were classified arthroscopically as incomplete (92%) or complete (8%); no Wrisberg-type lesions were noted. Three patients (14%) had bilateral lesions. Symptomatic torn discoid menisci (20 knees) and torn discoid menisci with other significant symptomatic lesions (3 knees) underwent arthroscopic partial lateral meniscectomy utilizing the saucerization technique. Asymptomatic intact discoid menisci (2 knees) were left unresected. Using the knee scale of Ikeuchi, 55% of the symptomatic torn lesions were rated as excellent or good, 30% were rated as fair, and 15% were rated as poor at follow-up. Two of the 3 asymptomatic torn lesions were rated as excellent or good, as were both of the intact discoid lesions. Factors associated with an unsatisfactory rating at follow-up included preexistent degenerative changes, age, and sex. Duration of symptoms, type of discoid tear, and length of follow-up were not necessarily related to outcome results. Seven knees (28%) required arthroscopic reevaluation at a postoperative average of 23 months, documenting apparent physiologic function of the saucerized rim in 4 patients and failure of saucerization in 3 patients (12%). Overall, 14 of the 22 patients in this study (64%) resumed a normal activity level postoperatively, including 61% of those with symptomatic torn discoid lateral menisci.

摘要

对22例患者(25个膝关节)进行了评估,平均随访54个月,以观察关节镜治疗盘状外侧半月板综合征的临床效果。关节镜下将盘状外侧半月板分为不完全型(92%)或完全型(8%);未发现Wrisberg型损伤。3例患者(14%)为双侧病变。有症状的撕裂盘状半月板(20个膝关节)和伴有其他明显症状性损伤的撕裂盘状半月板(3个膝关节)采用碟形化技术进行了关节镜下部分外侧半月板切除术。无症状的完整盘状半月板(2个膝关节)未予切除。根据池内膝关节评分标准,随访时55%有症状的撕裂病变评为优或良,30%评为一般,15%评为差。3例无症状撕裂病变中有2例评为优或良,2例完整盘状病变也评为优或良。随访时评分不满意的相关因素包括术前退变、年龄和性别。症状持续时间、盘状撕裂类型和随访时间不一定与结果相关。7个膝关节(28%)术后平均23个月需要关节镜重新评估,4例患者记录了碟形化边缘的明显生理功能,3例患者(12%)出现碟形化失败。总体而言,本研究中22例患者中有14例(64%)术后恢复了正常活动水平,包括61%有症状的撕裂盘状外侧半月板患者。

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