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半月板切除术后的晚期退行性改变。影响术后膝关节的因素。

Late degenerative changes after meniscectomy. Factors affecting the knee after operation.

作者信息

Allen P R, Denham R A, Swan A V

出版信息

J Bone Joint Surg Br. 1984 Nov;66(5):666-71. doi: 10.1302/0301-620X.66B5.6548755.

Abstract

Late degenerative changes are known to follow meniscectomy, but there is little agreement on their incidence or on which patients are most at risk. A total of 210 patients have been reviewed 10 to 22 years after meniscectomy, and long leg radiographs taken of both knees. Radiological degeneration was seen in 18%, while 7% had significant symptoms and signs. Statistical analysis showed increased changes in older patients, in those with abnormal leg alignment, and in those who had undergone lateral as against medial meniscectomy. Our findings emphasise the important mechanical function of the meniscus and support the current cautious approach to meniscectomy, especially for patients in high risk groups. They also indicate the value of early high tibial osteotomy for symptomatic varus deformity after medial meniscectomy.

摘要

已知半月板切除术后会出现晚期退行性改变,但对于其发生率以及哪些患者风险最高,人们的意见并不统一。对210例患者在半月板切除术后10至22年进行了复查,并对双膝关节进行了长腿X线摄片。发现18%的患者有放射学退变,而7%的患者有明显的症状和体征。统计分析表明,老年患者、下肢力线异常的患者以及接受外侧半月板切除术而非内侧半月板切除术的患者,其退变改变更多。我们的研究结果强调了半月板重要的机械功能,并支持目前对半月板切除术采取的谨慎态度,尤其是对于高危组患者。这些结果还表明,对于内侧半月板切除术后出现症状性内翻畸形的患者,早期高位胫骨截骨术具有重要价值。

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