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前交叉韧带损伤膝关节的关节镜下半月板切除术

Arthroscopic meniscectomy in the anterior cruciate ligament-deficient knee.

作者信息

Hanley S T, Warren R F

出版信息

Arthroscopy. 1987;3(1):59-65. doi: 10.1016/s0749-8063(87)80012-9.

Abstract

Patients with injury to the anterior cruciate ligament (ACL) frequently develop tears of the menisci. Removal of the meniscus, while relieving some complaints, may increase the patient's instability. To evaluate our success and quantify the reasons for failure, we evaluated 48 patients who underwent arthroscopic partial meniscectomy from 1979 to 1982. Patients were evaluated as to their subjective complaints, scored on a 100-point knee evaluation, and evaluated with standing x-rays. In addition, measurement using the KT-1000 knee arthrometer was made to assess the degree of tibial translation. Follow-up averaged 32 months, with a range of 24-50. At followup, 29 patients (60%) were judged to be clinical successes with resolution of their complaints and no aggravation of their instability. Nineteen patients (40%) were judged to be clinical failures in that their complaints persisted (14 patients) or ACL reconstruction was required (5 patients). Eight patients noted some increase in their instability, and three required a repeat meniscectomy. Arthroscopic partial meniscectomy can be a useful procedure in some patients with injury to the ACL. Patients more likely to do well are those with a torn medial meniscus with a chief complaint of locking. Examination would demonstrate a mild pivot shift, absence of generalized ligamentous laxity, and an anterior tibial translation difference of less than 5 mm.

摘要

前交叉韧带(ACL)损伤的患者经常会出现半月板撕裂。切除半月板虽然能缓解一些症状,但可能会增加患者的关节不稳定。为了评估我们的手术成功率并量化失败原因,我们对1979年至1982年间接受关节镜下部分半月板切除术的48例患者进行了评估。对患者的主观症状进行评估,采用100分制的膝关节评估评分,并进行站立位X线检查。此外,使用KT-1000膝关节测压仪进行测量,以评估胫骨平移程度。随访平均32个月,范围为24至50个月。随访时,29例患者(60%)被判定为临床成功,症状消失且关节不稳定未加重。19例患者(40%)被判定为临床失败,其中14例患者症状持续存在,5例患者需要进行ACL重建。8例患者注意到关节不稳定有所增加,3例患者需要再次进行半月板切除术。关节镜下部分半月板切除术对一些ACL损伤的患者可能是一种有用的手术方法。更有可能预后良好的患者是内侧半月板撕裂且主要症状为交锁的患者。检查会显示轻度的轴移试验阳性、无全身性韧带松弛,且胫骨前移差异小于5毫米。

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