Department of Orthopedics, Banan Hospital of Chongqing Medical University, China.
Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, China.
Knee. 2022 Aug;37:171-179. doi: 10.1016/j.knee.2022.06.010. Epub 2022 Jul 6.
This study aimed to explore the changes in lower limb axial alignment and knee joint function after arthroscopic partial resection of the discoid lateral meniscus.
Preoperative and postoperative full-length weight-bearing radiographs of the lower limb were obtained from a total of 161 patients with lateral menisci tears from September 2018 to September 2020 who underwent partial meniscal resection. The patients were divided into discoid meniscus group (DMG) and ordinary meniscus group (OMG). The measured mechanical axis deviation (MAD), proximal tibia angle (PTA), and distal femoral angle (DFA) in the axial alignment of the lower limb were determined before and after surgery. Knee joint function on the affected side was determined using the International Knee Documentation Committee (IKDC) subjective scale and the Lysholm knee scoring scale before surgery and at one, six, 12, and 24 months after surgery.
For MAD and DFA, there were statistically significant differences between the preoperative and postoperative findings within each group (P < 0.01); the MAD and DFA were smaller after surgery. The difference in preoperative and postoperative PTA of the DMG was statistically significant (P < 0.01), meaning that the PTA becomes larger after surgery. The differences in preoperative and postoperative PTA of the OMG, preoperative PTA between the two groups, and postoperative PTA between the two groups were not statistically significant (P > 0.05). Intragroup comparisons of the IKDC subjective scale and the Lysholm knee scoring scale before and after surgery revealed significant differences (P < 0.05).
Arthroscopic partial resection of the discoid lateral meniscus is a safe and effective surgical method that can significantly improve knee joint function. Although the axial arrangement of the lower limbs will be slightly changed in the early stage, it will still be within the normal range after surgery in patients with normal lower limb axial alignment. For patients with varus or valgus before surgery, this procedure should be applied with caution.
本研究旨在探讨关节镜下部分切除盘状外侧半月板后下肢轴向对线和膝关节功能的变化。
对 2018 年 9 月至 2020 年 9 月行部分半月板切除术的外侧半月板撕裂患者共 161 例的术前和术后下肢全长负重位 X 线片进行回顾性分析，根据半月板形态分为盘状半月板组（DMG）和普通半月板组（OMG）。测量下肢轴向对线的机械轴偏差（MAD）、胫骨近端角（PTA）和股骨远端角（DFA），比较手术前后膝关节功能的国际膝关节文献委员会（IKDC）主观评分和 Lysholm 膝关节评分。
对于 MAD 和 DFA，各组内术前与术后比较差异均有统计学意义（P<0.01）；术后 MAD 和 DFA 均减小。DMG 术前与术后 PTA 差异有统计学意义（P<0.01），即术后 PTA 增大。OMG 组术前与术后 PTA 差异无统计学意义（P>0.05），两组间术前 PTA 差异无统计学意义（P>0.05），两组间术后 PTA 差异亦无统计学意义（P>0.05）。两组内手术前后 IKDC 主观评分和 Lysholm 膝关节评分比较差异均有统计学意义（P<0.05）。
关节镜下部分切除盘状外侧半月板是一种安全有效的手术方法，可明显改善膝关节功能。虽然下肢轴向排列在早期会有轻微改变，但在下肢轴向排列正常的患者中，术后仍在正常范围内。对于术前存在内翻或外翻的患者，应谨慎应用该术式。
