摘要
目的 总结盘状软骨的关节镜下治疗的方法和疗效及临床特点 ,为日后更好的诊治盘状半月板提供依据。方法 31例(31膝 )盘状软骨患者分别采用关节镜下成形术 2 7例和全切术 3例、 1例边缘撕裂成形后缝合修补术。结果 按Ikeuchi氏膝关节评价等级评定疗效 :优 17例 (5 4 8%) ,良 11例 (35 5 %) ,可 3例 (9 7%)。 3例术后自述有弹响 ,查体见其中 2例有外侧半月残留部不稳的体征。结论 盘状软骨在膝关节屈伸运动中所产生的非生理性运动 ,易造成盘状软骨的破裂、关节软骨磨损以至关节软骨早期出现退行性改变等 ,症状性盘状软骨一旦发现 ,无论破裂与否均应早期手术。关节镜下盘状软骨成形术可获得优良疗效。盘状软骨引发的弹响交锁有其特征性临床特点 ;MRI对盘状软骨诊断有确诊意义。
Objective To evaluate retrospectively the curative effect of arthroscopic surgery and the particular clinical features of the discoid meniscus.Methods Thirty-one patients with 31 discoid lateral menisci were underwent arthroscopic lateral partial or total meniscectomy for discoid lateral meniscus.Twenty-seven discoid lateral menisci underwent reshaping (partial meniscectomy),which were performed to achieve a smooth meniscus and a strong,stable peripheral rim,and 3 cases underwent total meniscectomy under arthroscopy.Arthroscopic total meniscectomy was performed in the 2 complete types.One discoid meniscus was reshaped with repair of a peripheral tear.Results Based on Ikeuchis grading(Ikeuchi 1982),54.8% of the knees had an excellent result,35.5% had a good result and 9.7% had a fair result:none was poor.The symptoms of unstable peripheral rim were tested postoperatively in 2 cases.Conclusion Patients with a discoid meniscus who are symptomatic should undergo arthroscopy.Arthroscopic reshaping(partial meniscectomy)is recommended,regardless of discoid meniscal tear.A reshaping should be performed to achieve a smooth meniscus and a strong,stable peripheral rim.A total meniscectomy is indicated for these discoid menisci whose peripheral rim isstability after being reshaped could not be repaired.Only a part of patients with a discoid meniscus have a abnormal X-ray film.but MRI is essential to all patients with a discoid meniscus.
出处
《骨与关节损伤杂志》
2001年第5期339-341,I001,共4页
The Journal of Bone and Joint Injury
