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关节镜下半月板切除术后的长期结果。60例患者13年随访中既往存在的软骨原纤维形成的作用。

Long-term results after arthroscopic meniscectomy. The role of preexisting cartilage fibrillation in a 13 year follow-up of 60 patients.

作者信息

Rockborn P, Gillquist J

机构信息

Faculty of Health Sciences, Linköping University, Sweden.

出版信息

Int J Sports Med. 1996 Nov;17(8):608-13. doi: 10.1055/s-2007-972903.

Abstract

Sixty patients with stable knees and arthroscopic menisectomy were matched into two groups according to the presence of early degenerative changes at the operation. Patients with severe cartilage changes were excluded. The patients were between 20 and 40 years of age at the operation and no patient had previous surgery on the involved knee. The intraarticular findings were documented at surgery and the patients were re-examined 12 to 15 years after the meniscectomy. Pre-existing cartilage fibrillation at the meniscectomy did not seem to influence the long-term results. At the follow-up no difference was found between the groups at the physical examination, in subjective complaints, in knee function and activity or in radiographic findings. In the total group 62% had early signs of arthrosis (Fairbank changes) and 42% narrowing of the joint space (Ahlbäck grade 1-2) in the operated knee. No one had more severe changes. Radiographic signs of arthrosis were 4 times commoner in the operated knee compared to the non-operated knee after partial meniscectomy and 7 times commoner in the operated knee after subtotal meniscectomy. Arthrosis at the follow-up was seen three times more often in patients older than 30 years of age at surgery than in younger patients. The functional outcome was good and 70% were still active in sports compared to 90% before the operation.

摘要

60例膝关节稳定且接受关节镜下半月板切除术的患者,根据手术时是否存在早期退变改变分为两组。排除有严重软骨改变的患者。患者手术时年龄在20至40岁之间,且受累膝关节此前均未接受过手术。术中记录关节内情况,并在半月板切除术后12至15年对患者进行复查。半月板切除术时已存在的软骨纤维化似乎不影响长期结果。随访时,两组在体格检查、主观症状、膝关节功能和活动情况或影像学表现方面均未发现差异。在整个研究组中,62%的患者手术膝关节有早期骨关节炎迹象(费尔班克改变),42%有关节间隙变窄(阿尔贝克1 - 2级)。部分半月板切除术后,手术膝关节出现骨关节炎的影像学迹象是非手术膝关节的4倍,次全半月板切除术后则为7倍。随访时,手术时年龄大于30岁的患者出现骨关节炎的频率是年轻患者的3倍。功能结果良好,70%的患者仍能积极参与运动,而术前这一比例为90%。

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