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膝关节镜下内侧副韧带部分松解:不同技术与功能结果。

Medial collateral ligament partial release in knee arthroscopy: different techniques and functional outcomes.

机构信息

Department of Orthopedics, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia.

出版信息

Eur Rev Med Pharmacol Sci. 2022 Mar;26(6):1860-1867. doi: 10.26355/eurrev_202203_28331.

Abstract

OBJECTIVE

The current study was aimed at reviewing the literature systematically to educe enhanced understanding of various techniques, sequels, as well as complications after percutaneous MCL lengthening through the procedure of arthroscopy of the knee; moreover, we utilize this clinical data that will help surgeons to encompass this technical gesticulation into their day-to-day surgical practice.

MATERIALS AND METHODS

The inclusion criteria were framed as per the internationally standardized PICOS framework, as recommended by PRISMA guidelines. The study population included adults who underwent arthroscopic knee surgery for sMCL lengthening.

RESULTS

After evaluation of 69 papers, only 9 studies were ascertained for analysis after these papers fulfilled both inclusion and exclusion criteria. The patient's age varied from 13 to 60 years at the time of commencement of surgery. There was no record of any perioperative complications in relation to iatrogenic chondral damage, fracture, and there was no report of any additional meniscal injury. The requirement of postoperative bracing was reported in 2 studies, and that was required for a time period of about 4 weeks after lengthening, while various other authors reported no use of postoperative bracing. Furthermore, in relation to postoperative pain, mild pain at the medial needle tract site was experienced by patients in two that lasted up to 15 days. None of the studies reported any case of saphenous vein or saphenous nerve injury. The duration of the final follow-up after surgery varied from 3 weeks to 24 months. No incidence of subjective instability was accounted for.

CONCLUSIONS

Thus, the present study concludes that percutaneous lengthening is effective with well-documented benefits with minimum allied risks and can be recommended for surgeons' who perform arthroscopy of the posteromedial compartment of the knee in the presence of a tight medial compartment. Furthermore, data reveal that healing is not impaired, or the risk of postoperative complications does not upsurge without the use of bracing.

摘要

目的

本研究旨在系统地回顾文献,深入了解经膝关节关节镜行 MCL 经皮延长术的各种技术、后续情况和并发症;此外,我们利用这些临床数据帮助外科医生将这项技术纳入日常手术实践。

材料和方法

纳入标准根据国际标准化 PICOS 框架制定,符合 PRISMA 指南建议。研究人群包括接受膝关节关节镜下 sMCL 延长术的成年人。

结果

在评估了 69 篇论文后,只有 9 项研究符合纳入和排除标准,被确定进行分析。手术时患者年龄为 13 至 60 岁。没有记录到与医源性软骨损伤、骨折相关的围手术期并发症,也没有报告任何半月板损伤。2 项研究报告了术后支具的需求,支具需要在延长后约 4 周内使用,而其他一些作者报告不需要使用术后支具。此外,关于术后疼痛,有 2 项研究报告患者在经内侧针道部位有轻度疼痛,持续 15 天。没有研究报告任何隐静脉或隐神经损伤的病例。术后最终随访的时间从 3 周到 24 个月不等。没有报告任何主观不稳定的病例。

结论

因此,本研究表明,经皮延长术是有效的,具有明确的益处,风险最小,可以推荐给在膝关节后内侧间隔紧张的情况下进行膝关节关节镜检查的外科医生。此外,数据显示,不使用支具不会影响愈合或增加术后并发症的风险。

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