Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Arthroscopy, Joint Research Institute, Yonsei University Health System, Seoul, Republic of Korea.
Knee Surg Sports Traumatol Arthrosc. 2018 Oct;26(10):2912-2919. doi: 10.1007/s00167-017-4827-9. Epub 2017 Dec 28.
To analyze the effect of percutaneous pie-crusting medial release on valgus laxity before and after surgery and on clinical outcomes.
Eight-hundred fourteen consecutive patients who underwent an arthroscopic procedure for the medial compartment of the knee were evaluated retrospectively. Sex, age, type of operation (meniscectomy, meniscal repair, and posterior root repair), type of accompanying surgery (none, cartilage procedure, ligament procedure and osteotomy) were documented. Sixty-four patients who underwent percutaneous pie-crusting medial release (release group) and 64 who did not undergo medial release (non-release group) were matched using the propensity score method. Each patient was evaluated for the following variables: degree of valgus laxity on stress radiographs, Lysholm knee score, visual analog scale score, and International Knee Documentation Committee knee score and grade.
At the 24-month follow-up, no significant increase in side-to-side differences in the valgus gap was observed in comparison to the preoperative value in the release group [preoperative, - 0.1 ± 1.3 mm; follow-up, - 0.1 ± 1.4 mm; (n.s.)]. The follow-up Lysholm score, visual analog scale score and International Knee Documentation Committee knee score and grade were similar between the two groups.
Percutaneous pie-crusting medial release is an additional procedure that can be performed during arthroscopic surgery for patients with a narrow medial joint space of the knee. Percutaneous pie-crusting medial release reduces iatrogenic injury to the cartilage and does not produce any residual valgus laxity of the knee.
IV.
分析关节镜下内侧皮瓣切开术对内翻松弛度的术前、术后影响及临床疗效。
回顾性分析 814 例膝关节内侧间室关节镜手术患者。记录性别、年龄、手术类型（半月板切除术、半月板修复术和后根修复术）、伴随手术类型（无、软骨手术、韧带手术和截骨术）。采用倾向评分匹配法，将 64 例行关节镜下内侧皮瓣切开术（切开组）和 64 例未行内侧皮瓣切开术（未切开组）的患者进行匹配。每组患者均评估以下变量：内外翻应力位 X 线片上的外翻松弛度、Lysholm 膝关节评分、视觉模拟评分和国际膝关节文献委员会膝关节评分和分级。
在 24 个月的随访中，与术前相比，切开组的外翻间隙侧间差异无显著增加[术前，-0.1±1.3mm；随访，-0.1±1.4mm；（n.s.）]。两组患者的随访 Lysholm 评分、视觉模拟评分和国际膝关节文献委员会膝关节评分和分级相似。
关节镜下内侧皮瓣切开术是一种额外的手术方法，可用于膝关节内侧关节间隙狭窄的患者。关节镜下内侧皮瓣切开术可减少对软骨的医源性损伤，不会导致膝关节残留外翻松弛。
IV 级。
