Bolano L E, Grana W A
Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma, Oklahoma City.
Am J Sports Med. 1993 May-Jun;21(3):432-7. doi: 10.1177/036354659302100318.
Fifty patients who underwent isolated arthroscopic partial meniscectomy with a minimum followup of 5 years were analyzed retrospectively. To analyze the factors associated with a satisfactory or an unsatisfactory clinical result, we looked at the patient's age, duration of symptoms, type of meniscal lesion, and articular cartilage abnormalities. The patients were graded with a functional knee score (Lysholm-Gillquist), and activity level before surgery and at followup was determined. The data also included radiographic evaluation of 29 of the 50 patients. Tibiofemoral alignment was measured, and osteoarthritic changes were graded and correlated with the type of meniscal abnormality and functional result. Eighty-two percent of our patients had satisfactory knee function, and the activity level was maintained. The factors associated with a satisfactory result after a partial meniscectomy included age less than 40 years, symptoms less than 12 months duration, type of tear, and chondromalacia less than grade II. Fairbank's changes were present in 50% of the patients, with significant grade III and IV changes identified in 30%. Although the radiographic changes did not necessarily correlate with the functional result, we felt that the changes were significant and indicative of abnormal stress transfer to articular cartilage and bone.
对50例行单纯关节镜下部分半月板切除术且至少随访5年的患者进行回顾性分析。为分析与满意或不满意临床结果相关的因素,我们观察了患者的年龄、症状持续时间、半月板损伤类型以及关节软骨异常情况。采用膝关节功能评分(Lysholm - Gillquist评分)对患者进行分级,并确定手术前及随访时的活动水平。数据还包括对50例患者中29例的影像学评估。测量胫股关节对线情况,对骨关节炎改变进行分级,并将其与半月板异常类型及功能结果相关联。我们82%的患者膝关节功能满意,且活动水平得以维持。部分半月板切除术后获得满意结果的相关因素包括年龄小于40岁、症状持续时间小于12个月、撕裂类型以及软骨软化小于II级。50%的患者出现了Fairbank改变,其中30%有明显的III级和IV级改变。尽管影像学改变不一定与功能结果相关,但我们认为这些改变具有显著性,表明应力异常转移至关节软骨和骨骼。