关节镜辅助内侧副韧带浅层松解在内侧半月板损伤修复中的应用

发布时间：2018-04-26 01:27

本文选题：内侧副韧带松解 + 关节镜　；参考：《中国运动医学杂志》2017年01期

【摘要】：目的:对内侧半月板后角损伤的患者,采用关节镜下缝合修复方法,辅助内侧副韧带浅层结构局部松解,观察其术后疗效。方法:2014年3月至2014年10月,连续37例患者入选本研究。男23例,女14例,平均年龄36.7±9.2岁。单纯内侧半月板损伤6例,前交叉韧带合并内侧半月板损伤31例。缝合修复半月板时,对内侧副韧带浅层结构的后方纤维进行松解。半月板修复均采用自内向外缝合方法。术后随访时评估患者主观症状,有无关节交锁、内侧关节间隙疼痛,有无压痛,内侧副韧带稳定性。拍摄膝关节核磁共振片了解半月板愈合情况。结果:37例患者平均获得26.1±4.4个月的随访。31例患者为前交叉韧带损伤合并内侧半月板损伤,术后随访时膝关节稳定性KT-1000检查侧-侧差值平均为1.3±0.7 mm,与术前(7.1±2.2 mm)相比有显著差异(P0.01)。另6例患者接受单纯半月板缝合修复,膝关节无不稳定表现。全部患者膝关节内侧稳定性术后较术前无显著差异。3例患者主诉内侧关节间隙疼痛,无交锁现象。术后核磁共振片显示内侧半月板愈合率为81.1%。结论:关节镜下缝合修复方法治疗内侧半月板损伤,术后平均随访26.1个月,愈合率为81.1%。术中辅助内侧副韧带浅层组织局部松解,可以改善视野、提高操作效率,术后患者无内侧结构不稳定表现。
[Abstract]:Objective: to observe the effect of arthroscopic suture repair on the superficial structure of medial collateral ligament in patients with posterior horn injury of medial meniscus. Methods: from March 2014 to October 2014, 37 consecutive patients were enrolled in this study. There were 23 males and 14 females with an average age of 36.7 卤9.2 years. There were 6 cases of medial meniscus injury and 31 cases of anterior cruciate ligament combined with medial meniscus injury. The posterior fibers of the superficial structure of medial collateral ligament were loosened when meniscus was repaired by suture. Meniscus prostheses were sutured from inside to outside. The subjective symptoms, joint interlocking, pain in medial joint space, tenderness and stability of medial collateral ligament were evaluated during follow-up. To study meniscus healing by taking MRI film of knee joint. Results the mean follow-up time of 37 cases was 26.1 卤4.4 months. 31 cases had anterior cruciate ligament injury combined with medial meniscus injury. The lateral side difference of knee joint stability in KT-1000 was 1.3 卤0.7 mm after follow-up, which was significantly different from that before operation (7.1 卤2.2 mm). The other 6 patients underwent meniscus suture and no instability of knee joint. There was no significant difference in medial knee joint stability after operation. 3 patients complained of medial joint space pain without locking. MRI showed that the healing rate of medial meniscus was 81.1%. Conclusion: arthroscopic suture repair for medial meniscus injury was followed up for an average of 26.1 months and the healing rate was 81.1%. The local release of medial collateral ligament can improve the visual field and improve the operation efficiency. There is no instability of medial structure in patients after operation.
【作者单位】：北京积水潭医院运动医学科;
【分类号】：R687.4

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