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45岁以下患者内侧半月板水平劈裂伤的关节镜下半月板切除术

Arthroscopic Meniscectomy for Medial Meniscus Horizontal Cleavage Tears in Patients under Age 45.

作者信息

Kim Jae Gyoon, Lee Seung-Yup, Chay Suhwoo, Lim Hong Chul, Bae Ji-Hoon

机构信息

Department of Orthopedic Surgery, Korea University Ansan Hospital, Ansan, Korea.

Department of Orthopedic Surgery, Seoul Barunsesang Hospital, Seoul, Korea.

出版信息

Knee Surg Relat Res. 2016 Sep;28(3):225-32. doi: 10.5792/ksrr.2016.28.3.225. Epub 2016 Aug 25.

Abstract

PURPOSE

The purpose of this study was to evaluate the demographics, clinical features, and outcomes of arthroscopic partial meniscectomy (APM) for isolated medial meniscus horizontal cleavage tears (MMHCTs) in patients under 45 years of age.

MATERIALS AND METHODS

We retrospectively reviewed 98 patients (100 knees) under 45 years who underwent APM for MMHCTs. Clinical outcomes were assessed using International Knee Document Committee (IKDC) subjective core, Tegner activity scale, visual analog scale (VAS) pain score, and a question on the symptom relief.

RESULTS

79% were male and 70% had no trauma. The mean symptom duration was 10 months. At arthroscopy, a flap tear was identified in 75%. At a mean of 19-month follow-up, the IKDC subjective score, Tegner activity scale, and VAS pain score were significantly improved compared to the preoperative values (p=0.025, p=0.043, and p=0.032, respectively). While 85% were free of symptoms, 15% had persistent pain. No significant differences in outcomes were observed based on the tear type and the presence of flap tears. No progression or development of radiographic degenerative changes was observed in all knees.

CONCLUSIONS

Demographics of MMHCTs under age 45 showed a male dominance and higher frequency of non-traumatic tears. APM was beneficial to symptomatic HCTs in this cohort during the short-term follow-up. Type of HCTs and combined flap tears did not affect clinical outcomes.

摘要

目的

本研究旨在评估45岁以下患者因孤立性内侧半月板水平劈裂撕裂(MMHCT)接受关节镜下部分半月板切除术(APM)的人口统计学特征、临床特征及手术结果。

材料与方法

我们回顾性分析了98例(100膝)45岁以下因MMHCT接受APM的患者。使用国际膝关节文献委员会(IKDC)主观核心评分、 Tegner活动量表、视觉模拟量表(VAS)疼痛评分以及关于症状缓解的问题对临床结果进行评估。

结果

79%为男性,70%无创伤史。平均症状持续时间为10个月。关节镜检查时,75%发现有瓣状撕裂。平均随访19个月时,IKDC主观评分、Tegner活动量表评分和VAS疼痛评分与术前值相比均有显著改善(分别为p = 0.025、p = 0.043和p = 0.032)。85%无症状,15%仍有持续疼痛。根据撕裂类型和瓣状撕裂的存在情况,未观察到结果有显著差异。所有膝关节均未观察到影像学退变改变的进展或发展。

结论

45岁以下MMHCT的人口统计学特征显示男性占主导且非创伤性撕裂的频率更高。在短期随访中,APM对该队列中有症状的HCT患者有益。HCT的类型和合并的瓣状撕裂不影响临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60bc/5009048/e9750e7e4621/ksrr-28-225-g001.jpg

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