| 经皮穿刺内侧副韧带深层松解技术在膝内侧半月板后角手术中的应用 |
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Received:December 17, 2019
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| 作者 | Author | 单位 | Unit | E-Mail |
| 黄炳哲 |
HUANG Bing-zhe |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
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| 于海驰 |
YU Hai-chi |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
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| 李颖智 |
LI Ying-zhi |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
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| 曲成远 |
QU Cheng-yuan |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
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| 郭德明 |
GUO De-ming |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
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| 王亚雄 |
WANG Ya-xiong |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
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| 刘晓宁 |
LIU Xiao-ning |
吉林大学第二医院骨科医学中心, 吉林 长春 130041 |
Orthopaedic Medical Center, the 2nd Hospital of Jilin University, Changchun 130041, Jilin, China |
liuxy99@jlu.edu.cn |
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| 期刊信息：《中国骨伤》2020年33卷，第10期，第938-942页 |
| DOI：10.12200/j.issn.1003-0034.2020.10.010 |
| 基金项目:吉林省教育厅“十三五”科学技术项目（编号：JJKH20190057KJ） |
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目的：探讨采用经皮穿刺内侧副韧带深层松解技术对伴有内侧间室狭窄的膝内侧半月板后角撕裂患者的临床及影像学结果影响。
方法：自2012年1月至2016年12月，采用经皮穿刺内侧副韧带深层松解技术治疗内侧半月板后角损伤患者35例，男21例，女14例；年龄21～55（39.1±6.5）岁。MRI测量术前及术后24个月半月板外凸程度；膝关节外翻应力试验评估内侧副韧带稳定性并比较手术前后患侧-健侧的差值；比较术前及术后24个月Lysholm评分和IKDC功能评分。
结果：所有患者获得随访，时间27～60（36.7±6.8）个月。35例患者均顺利完成手术，伤口愈合良好，无并发症发生。手术时间0.5～1.2（0.8±0.4）h；35例患者中，19例行半月板部分切除术，16例行修复缝合术。术前半月板外凸（1.5±0.7）mm与术后（1.7±0.4）mm比较差异无统计学意义（P>0.05）。Lysholm评分由术前的（53.4±8.8）分提高至术后24个月的（91.5±4.6）分，差异有统计学意义（P<0.05）；IKDC评分由术前的（50.7±9.2）分提高至术后24个月（90.6±3.9）分，差异有统计学意义（P<0.05）；患侧膝关节在0°位和屈膝30°位接受外翻应力试验测试并与健侧对比，全部患者均为阴性。
结论：对于存在膝关节内侧间室狭窄的内侧半月板后角撕裂患者，膝关节镜下采用经皮穿刺内侧副韧带深层松解技术能够改善内侧间室操作空间，并且不产生膝外翻松弛和半月板外凸。 |
| [关键词]:内侧副韧带,膝 半月板 关节囊松解 关节穿刺术 |
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| Application of percutaneous pie-crusting deep medial collateral ligament release for posterior horn surgery of medial meniscus |
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Abstract:
Objective: To explore clinical and radiographic effects of percutaneous pie-crusting deep medial collateral ligament release in patients with posterior horn tear of medial meniscus combined with tight medial compartment.
Methods: From January 2012 to December 2016,35 patients with medial meniscus posterior horn injury were treated with percutaneous pie-crusting deep medial collateral ligament release technique,including 21 males and 14 females,aged from 21 to 55 years old with an average of (39.1±6.5) years old. Degree of meniscus extrusion were recorded before and 24 months after operation. The knee valgus stress test was performed to evaluate stability of medial collateral ligament,and compared difference between healthy and affected side. Lysholm and IKDC functional scores were compared before and 24 months after operation.
Results: All patients were followed up from 27 to 60 months with an average of(36.7±6.8) months. All patients were underwent operation,the wound healed well without complications. Operative time ranged from 0.5 to 1.2 h with an average of(0.8±0.4) h. Nineteen patients were performed partial meniscectomy,16 patients were performed repair suture. Convex of meniscus before operation was (1.5±0.7) mm,and (1.7±0.4) mm after operation;had no statistical difference(P>0.05). Lysholm score was improved from 53.4±8.8 before operation to 91.5±4.6 at 24 months after operation;IKDC score was increased from 50.7±9.2 before operation to 90.6±3.9 at 24 months after operation;there was statistically significant(P<0.05). Valgus stress test was performed on 0° and 30° position of knee flexion in affected side and compared with ipsilateral side,all patients showed negative.
Conclusion: For patients with medial meniscus tear of posterior horn combined with tight medial compartment,percutaneous pie-crusting deep medial collateral ligament release could improve medial compartment space,and Knee valgus instability and meniscus extrusion are not affected. |
| KEYWORDS:Medial collateral ligament,knee Meniscus Joint capsule release Arthrocentesis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄炳哲,于海驰,李颖智,曲成远,郭德明,王亚雄,刘晓宁.经皮穿刺内侧副韧带深层松解技术在膝内侧半月板后角手术中的应用[J].中国骨伤,2020,33(10):938~942 |
| 英文格式: | HUANG Bing-zhe,YU Hai-chi,LI Ying-zhi,QU Cheng-yuan,GUO De-ming,WANG Ya-xiong,LIU Xiao-ning.Application of percutaneous pie-crusting deep medial collateral ligament release for posterior horn surgery of medial meniscus[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(10):938~942 |
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