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半月板修复的关节镜评估。影响愈合的因素。

Arthroscopic evaluation of meniscal repairs. Factors that effect healing.

作者信息

Tenuta J J, Arciero R A

机构信息

Orthopaedic Service, United States Military Academy, West Point, New York.

出版信息

Am J Sports Med. 1994 Nov-Dec;22(6):797-802. doi: 10.1177/036354659402200611.

Abstract

Fifty-one patients with 54 meniscal repairs were evaluated with second-look arthroscopy and physical examination at an average of 11 months (range, 4 to 30) after repair. Thirty-five of 54 repairs (65%) were completely healed and 9 repairs were incompletely healed, for an overall satisfactory healing rate of 81% (44 of 54 repairs). Ten repairs did not heal (19%). An anterior cruciate ligament reconstruction combined with meniscal repair increased meniscal healing--36 of 40 (90%) healed versus 8 of 14 (57%) in cruciate stable knees. Rim width was a significant factor; no meniscal repair with a rim width greater than 4 mm healed. Meniscal repair with anterior cruciate ligament reconstruction in patients less than 30 years old and performed within 19 weeks of injury resulted in improved healing rates. In patients with simultaneous meniscal repair and anterior cruciate ligament reconstruction, a higher rate of complete healing (16 of 19 repairs, 84%) was observed after the conservative rehabilitation program. Those who followed the aggressive program had a complete healing rate of 63% (12 of 19 repairs). Satisfactory healing (complete plus incomplete arthroscopic healing) was similar for both groups, 89% and 90%, respectively.

摘要

51例接受54次半月板修复的患者在修复后平均11个月(范围4至30个月)接受了二次关节镜检查和体格检查。54次修复中有35次(65%)完全愈合,9次修复不完全愈合,总体满意愈合率为81%(54次修复中的44次)。10次修复未愈合(19%)。前交叉韧带重建联合半月板修复可提高半月板愈合率——40次修复中有36次(90%)愈合,而在交叉韧带稳定的膝关节中,14次修复中有8次(57%)愈合。边缘宽度是一个重要因素;边缘宽度大于4mm的半月板修复无一愈合。在小于30岁且在受伤后19周内进行前交叉韧带重建的患者中,半月板修复的愈合率有所提高。在同时进行半月板修复和前交叉韧带重建的患者中,保守康复方案后观察到更高的完全愈合率(19次修复中的16次,84%)。遵循积极康复方案的患者完全愈合率为63%(19次修复中的12次)。两组的满意愈合(完全愈合加关节镜下不完全愈合)相似,分别为89%和90%。

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