摘要
目的对65例关节镜下盘状半月板成形术的临床效果进行总结,分析影响手术效果的可能因素,探讨盘状半月板关节镜下手术的指征和方法。方法选择1996年9月～2003年9月65例盘状半月板患者,其中男性29例,女性36例,年龄8～46岁,平均年龄21.3岁。65例中合并半月板破裂者50例,包括分层撕裂23例,桶柄状撕裂16例,瓣状撕裂11例。手术方法:应用美国Stryker及德国蛇牌关节镜系统,用30°镜观察,交替使用内侧和外侧切口置入不同角度篮钳和镜下电灼对半月板进行处理,保留半月板边缘6～8mm。结果65例患者术后均得到随访,随访时间6个月至24个月,平均14.3个月。手术后关节交锁症状全部消失。术后6个月根据Ikeuchi膝关节评分标准,优48例,良12例,一般5例。无术后功能差的病例。结论盘状半月板成形术可以最大程度地保留半月板的功能,延缓膝关节的退变,除Wisberg韧带型盘状半月板或合并严重撕裂者,应尽量采用此手术方法。应严格掌握该术式、适应证、禁忌证,避免影响手术效果的因素。
Objective To summarize the effect of arthroscopic discoid meniscus,analyse the possible factors influencing the outcome of operation and study the indication and technique of arthmscopic treatment in discoid meniscus. Methods A total of 65 cases of discoid meniscus were performed arthroscopic meniscus-plasty, 11 of those underwent total meniscectomy or subtotal resection from September in 1996 to September in 2003. There were 50 in 65 cases with meniscus tears,including layered tear （n = 23）,bucket handle tear （n = 16） and flap tear （n = 11）. The patients were operated with Stryker or Aesculap arthroscopic system. Mternative application of medial and lateral incisions and placing basket clamp in different angles and endoscopic electrocautery were performed. As for layered tear the floating layer was resected, and remained a crescent-shaped margin,Results Locking joint symptoms were disappeared in all cases after surgery during following up 6 - 24 months, According to Ikeuchi knee score criterion, there were excellent in 48 cases, good 12 cases, moderate 5 cases, Poor results were not found. Conclusion It is demonstrated that the meniscus-plasty in discoid meniscus cases can remain the most appropriate function of meniscus and delay the degeneration of knee joint, This technique should be performed in all discoid meniscus except the patients with wisberg ligament-discoid meniscus and severe tear of meniscus, Thus the operation techniques,its indications and contraindications should be mastered.
出处
《生物医学工程与临床》
CAS
2008年第3期203-205,共3页
Biomedical Engineering and Clinical Medicine
