摘要
目的探讨拉花松解技术(Pie-crusting)在膝内侧半月板后角损伤中的应用及对步态特征的影响。方法前瞻性研究2022年1月-2023年12月昆明医科大学第一附属医院收治的膝内侧半月板后角损伤患者112例,随机数字表法分为观察组和对照组,各56例。两组均行关节镜手术,观察组采取Pie-crusting技术松解,对照组采取常规松解。统计两组患者手术及术后情况、影像学评估结果、并发症,并比较术前及术后3、6个月步态特征、膝关节Lysholm及Tegner评分。结果观察组手术时间(35.6±4.4)min短于对照组(39.7±4.5)min,松解操作时间(1.1±0.2)min短于对照组(3.3±0.4)min(P<0.05);两组患者术后3、6个月步速、步频、单腿支撑时间较术前升高,但两组间比较差异无统计学意义(P>0.05);术后3、6个月两组患者Lysholm及Tegner评分较术前升高,但两组间比较差异无统计学意义(P>0.05);术后6个月,两组患者半月板愈合情况、Outbridge软骨退变分级比较差异无统计学意义(P>0.05);观察组并发症总发生率5.4%,低于对照组19.6%(P<0.05)。结论Pie-crusting技术治疗膝内侧半月板后角损伤可缩短手术时间与松解操作时间,且可降低并发症发生率。
Objective To explore the application of Pie-crusting technique in posterior horn injury of the medial meniscus and its impact on gait characteristics.Methods A total of 112 patients with posterior horn injury of the medial meniscus and admitted to the First Affiliated Hospital of Kunming Medical University from Jan.2022 to Dec.2023 were prospectively selected and randomly divided into observation and control groups according to the random number table method,with 56 cases in each group.Both groups underwent arthroscopic surgery,with the observation group adopting the Pie-crusting technique for release and the control group conventional release.The operation and postoperative conditions,imaging evaluation results and complications of the two groups were statistically analyzed,and the gait characteristics,as well as the knee joint functions by Lysholm score,Tegner score,etc.,before and 3 and 6 months after surgeries were compared.Results Compared with the control group,the observation group showed much shorter operation time(min,35.6±4.4 vs.39.7±4.5)and release operation time(min,1.1±0.2 vs.3.3±0.4)(both P<0.05);at postoperative 3 and 6 months,both groups showed significantly improved walking speed,step frequency and single leg support time than those before operation,but inter group comparisons revealed no significant difference(P>0.05),and the Lysholm and Tegner scores showed consistent results.At 6 months after surgery,there was no significant difference between the two groups(P>0.05)in terms of meniscus healing or Outbridge cartilage degeneration.However,the total incidence of complications was much lower in the observation group than in the control group(5.4%vs.19.6%,P<0.05).Conclusion Pie-crusting technique for the treatment of posterior horn injury of the medial meniscus can shorten the release operation time and the whole operation time,and reduce the incidence of complications,but shows comparable treatment efficiency with the conventional release method.
作者
王旭明
高旭丽
董明林
Wang Xuming;Gao Xuli;Dong Minglin(Department of Trauma Medical Center,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Department of Trauma Surgery,The Second Affiliated Hospital of Kunming Medical University,Kunming 650033,China)
出处
《创伤外科杂志》
2025年第10期767-772,共6页
Journal of Traumatic Surgery
基金
云南省卫生健康委临床医学中心2021-2023年建设任务(202205AF150058)。
