Huang Bing-Zhe, Yu Hai-Chi, Li Ying-Zhi, Qu Cheng-Yuan, Guo De-Ming, Wang Ya-Xiong, Liu Xiao-Ning
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China.
Zhongguo Gu Shang. 2020 Oct 25;33(10):938-42. doi: 10.12200/j.issn.1003-0034.2020.10.010.
To explore clinical and radiographic effects of percutaneous pie-crusting deep medial collateral ligament release in patients with posterior horn tear of medial meniscus combined with tight medial compartment.
From January 2012 to December 2016, 35 patients with medial meniscus posterior horn injury were treated with percutaneous pie crusting deep medial collateral ligament release technique, including 21 males and 14 females, aged from 21 to 55 years old with an average of (39.1±6.5) years old. Degree of meniscus extrusion were recorded before and 24 months after operation. The knee valgus stress test was performed to evaluate stability of medial collateral ligament, and compared difference between healthy and affected side. Lysholm and IKDC functional scores were compared before and 24 months after operation.
All patients were followed up from 27 to 60 months with an average of (36.7±6.8) months. All patients were underwent operation, the wound healed well without complications. Operative time ranged from 0.5 to 1.2 h with an average of (0.8±0.4) h. Nineteen patients were performed partial meniscectomy, 16 patients were performed repair suture. Convex of meniscus before operation was (1.5±0.7) mm, and (1.7±0.4) mm after operation;had no statistical difference(>0.05). Lysholm score was improved from 53.4±8.8 before operation to 91.5±4.6 at 24 months after operation;IKDC score was increased from 50.7±9.2 before operation to 90.6±3.9 at 24 months after operation;there was statistically significant (<0.05). Valgus stress test was performed on 0 ° and 30 ° position of knee flexion in affected side and compared with ipsilateral side, all patients showed negative.
For patients with medial meniscus tear of posterior horn combined with tight medial compartment, percutaneous pie-crusting deep medial collateralligament release could improve medial compartment space, and Knee valgus instability and meniscus extrusion are not affected.
探讨经皮“饼皮样”深层内侧副韧带松解术治疗内侧半月板后角撕裂合并内侧间室狭窄患者的临床及影像学效果。
2012年1月至2016年12月,对35例内侧半月板后角损伤患者采用经皮“饼皮样”深层内侧副韧带松解技术治疗,其中男21例,女14例,年龄21~55岁,平均(39.1±6.5)岁。记录术前及术后24个月时半月板挤出程度。进行膝关节外翻应力试验以评估内侧副韧带稳定性,并比较患侧与健侧差异。比较术前及术后24个月时的Lysholm和IKDC功能评分。
所有患者随访27~60个月,平均(36.7±6.8)个月。所有患者均接受手术,伤口愈合良好,无并发症。手术时间0.5~1.2小时,平均(0.8±0.4)小时。19例行半月板部分切除术,16例行修复缝合术。术前半月板凸出为(1.5±0.7)mm,术后为(1.7±0.4)mm;差异无统计学意义(>0.05)。Lysholm评分从术前的53.4±8.8提高至术后24个月时的91.5±4.6;IKDC评分从术前的50.7±9.2提高至术后24个月时的90.6±3.9;差异有统计学意义(<0.05)。在患侧膝关节屈曲0°和30°位进行外翻应力试验并与同侧比较,所有患者均为阴性。
对于内侧半月板后角撕裂合并内侧间室狭窄患者,经皮“饼皮样”深层内侧副韧带松解术可改善内侧间室空间,且不影响膝关节外翻不稳定及半月板挤出情况。