关节镜下钢丝引导缝合联合微骨折术修复膝关节外侧半月板后根部撕裂对膝关节本体感觉的影响

The effects of wire-guided suture under arthroscope combined with microfracture surgery on knee proprioception in the treatment of lateral meniscus posterior root tear

摘要:

目的 分析关节镜下钢丝引导缝合联合微骨折术修复膝关节外侧半月板后根部撕裂对膝关节本 体感觉的影响。方法 选取2015年3月—2018年2月成都医学院第二附属医院收治的膝关节外侧半月板后根 部撕裂患者118例作为研究对象。根据手术方式分为观察组60例和对照组58例。对照组行保守治疗，观察 组采用关节镜下钢丝引导缝合联合微骨折术治疗。比较两组治疗前后视觉模拟评分（VAS）评分、国际膝关 节评分委员会 （IKDC） 评分及Lysholm膝关节功能评分；分析观察组并发症发生情况。两组均接受1年随 访，比较两组膝关节本体感觉测试的差值。结果 观察组治疗前后VAS评分的差值高于对照组 （P <0.05）。 观察组治疗前后的 Lysholm 膝关节功能评分、IKDC 评分的差值高于对照组 （P <0.05）。观察组治疗前后 15°、45°及75°时的膝关节本体感觉测试差值的差值低于对照组 （P <0.05）。观察组与对照组并发症发生率 分别为0.00%和13.79%，观察组低于对照组 （P <0.05）。结论 关节镜下钢丝引导缝合联合微骨折术治疗膝 关节外侧半月板后根部撕裂的效果理想，有利于改善膝关节本体感觉。

Abstract:

Objective To analyze the effects of wire-guided suture under arthroscope combined with microfracture surgery on knee proprioception in the treatment of lateral meniscus posterior root tear. Methods A total of 118 patients with lateral meniscus posterior root tear treated in our hospital from March 2015 to February 2018 were selected as subjects. The clinical data of these patients were analyzed retrospectively. According to the surgical method, 58 patients in the control group were treated conservatively, while 60 patients in the observation group were treated with wire-guided suture under arthroscope combined with microfracture surgery. The visual analog scale (VAS) scores, the International Knee Documentation Committee (IKDC) scores and Lysholm knee scores were compared between the two groups before and after the treatment, and the complications were recorded and analyzed. The patients in both groups were followed up for 1 year to evaluate the effects of different treatments on knee proprioception. Results The difference of VAS scores before and after the treatment in the observation group was higher than that in the control group (t = 106.634, P < 0.05). Besides, the differences of Lysholm knee scores and IKDC scores before and after the treatment in the observation group were higher than those in the control group (t = 33.449, 28.824, P < 0.05). The differences of indexes in knee proprioception tests with the testing angle being 15°, 45°, and 75° before and after the treatment in the observation group were lower than those in the control group (t = 10.851, 9.935, 18.899, P < 0.05). The complication rate in the observation group was 0.00%, which was lower than 13.79% in the control group (χ2 = 8.878, P < 0.05). Conclusion The wire-guided suture under arthroscope combined with microfracture surgery is effective in treating lateral meniscus posterior root tear, and contributes to the improvement of the knee proprioception.