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关节镜下修复破裂半月板:1至6.3年随访

Arthroscopic repair of the ruptured meniscus: one to 6.3 years follow up.

作者信息

Jensen N C, Riis J, Robertsen K, Holm A R

机构信息

Department of Orthopaedic Surgery, Horsens Hospital, Denmark.

出版信息

Arthroscopy. 1994 Apr;10(2):211-4. doi: 10.1016/s0749-8063(05)80096-9.

DOI:10.1016/s0749-8063(05)80096-9
PMID:8003151
Abstract

Forty-nine patients underwent arthroscopic meniscal repair. Twenty-three had an isolated tear of the medial meniscus, four an isolated tear of the lateral meniscus, two a tear of the medial meniscus combined with a rupture of the medial collateral ligament, and 20 a tear of the anterior cruciate ligament (ACL) and a tear of one or both menisci. At the time of repair of the menisci, seven had undergone reconstruction of their ACL, whereas 13 had been treated conservatively for their ACL rupture. Seven of 10 retears were in patients with a conservatively treated ACL tear, and three were in patients with an isolated tear of a meniscus. Thirty-five patients without retears were reexamined after 5.5 years (1-6.3 years). The average Lysholm knee score before the trauma was 98 (range 75-100), and at follow-up it was 87 (range 29-100). The average Tegner's activity score before the trauma was 6 (range 3-9), and at follow-up it was 5 (range 0-9). When there is no retear, the clinical results of arthroscopic repair of the menisci are excellent. In those patients who had isolated lesions of the menisci, there were very few retears, 11% in this study. ACL deficiency of the knee greatly increases the risk of retear. In this study 46% of patients with persistent instability after an untreated ACL rupture incurred retears. There were no retears in the patients who underwent ACL reconstruction concomitant with the meniscal repair.

摘要

49例患者接受了关节镜下半月板修复术。其中23例为内侧半月板孤立性撕裂,4例为外侧半月板孤立性撕裂,2例为内侧半月板撕裂合并内侧副韧带断裂,20例为前交叉韧带(ACL)撕裂合并一侧或双侧半月板撕裂。在半月板修复时,7例患者已进行了ACL重建,而13例患者的ACL撕裂接受了保守治疗。10例再次撕裂患者中,7例为ACL撕裂接受保守治疗的患者,3例为半月板孤立性撕裂患者。35例未出现再次撕裂的患者在5.5年(1 - 6.3年)后接受了复查。创伤前平均Lysholm膝关节评分为98分(范围75 - 100分),随访时为87分(范围29 - 100分)。创伤前平均Tegner活动评分为6分(范围3 - 9分),随访时为5分(范围0 - 9分)。当没有再次撕裂时,关节镜下半月板修复的临床效果极佳。在那些半月板孤立性损伤的患者中,再次撕裂很少,本研究中为11%。膝关节ACL缺损会大大增加再次撕裂的风险。在本研究中,ACL撕裂未治疗后持续不稳定的患者中有46%发生了再次撕裂。半月板修复同时进行ACL重建的患者未出现再次撕裂。

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引用本文的文献

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Does Anterior Cruciate Ligament Reconstruction Protect the Meniscus and Its Repair? A Systematic Review.前交叉韧带重建能否保护半月板及其修复?一项系统评价。
Orthop J Sports Med. 2020 Jul 28;8(7):2325967120933895. doi: 10.1177/2325967120933895. eCollection 2020 Jul.
2
Failure of meniscal repair association with late anterior cruciate ligament reconstruction.半月板修复失败与晚期前交叉韧带重建相关。
J Orthop. 2015 Feb 18;13(2):106-9. doi: 10.1016/j.jor.2015.01.031. eCollection 2016 Jun.
3
Outcome of repaired unstable meniscal tears in children and adolescents.
儿童和青少年不稳定半月板撕裂的修复结果。
Acta Orthop. 2012 Jun;83(3):261-6. doi: 10.3109/17453674.2012.693017. Epub 2012 May 23.
4
Complications in brief: meniscus repair.简而言之:半月板修复的并发症。
Clin Orthop Relat Res. 2012 Jul;470(7):2059-66. doi: 10.1007/s11999-012-2303-x.
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Mid-term clinical results of medial meniscus repair with the meniscus arrow in the unstable knee.使用半月板箭钉修复不稳定膝关节内侧半月板的中期临床结果
Knee Surg Sports Traumatol Arthrosc. 2007 Feb;15(2):138-43. doi: 10.1007/s00167-006-0162-2. Epub 2006 Sep 12.
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A study for testing the sensitivity and reliability of the Lysholm knee scoring scale.一项关于测试Lysholm膝关节评分量表敏感性和可靠性的研究。
Knee Surg Sports Traumatol Arthrosc. 1996;4(1):27-31. doi: 10.1007/BF01565994.