CAJ | 학술논문

目的：总结不同年龄段患者非创伤性半月板损伤的关节镜下特点。方法按照纳入标准：（1）MRI确诊半月板III度损伤，（2）且有半月板损伤症状，（3）无明确急性外伤史和急性症状，（4）保守治疗无效，（5）在手术中确证为半月板损伤。纳入2012年全年全部非创伤性半月板损伤患者，以45岁为界分为两组。术前采集基本信息、症状、体征及Lysholm评分，术中记录半月板损伤的部位、类型、伴发损伤及手术方式。应用SPSS19.0（SPSS公司，美国）统计软件包进行统计分析，统计不同年龄段患者的发病频数，对不同年龄段患者的性别、患侧（左或右）、半月板损伤类型以及伴发损伤情况的比较采用χ2检验。结果共纳入患者201例，发病年龄呈双峰分布（20岁和60岁）。年轻患者外侧半月板损伤发生比例更高（单纯外侧半月板损伤占56.10%），而中老年患者则相反（单纯内侧半月板损伤占66.90%）。年轻患者内侧半月板损伤以纵行撕裂（27.80%）、鸟嘴样撕裂（38.90%）和水平撕裂（27.80%）为主；而中老年患者则以鸟嘴样撕裂（20.60%）、水平撕裂（27.20%）、根部损伤（19.10%）和复杂损伤（31.60%）为主。在外侧半月板，年轻患者以鸟嘴样撕裂（45.50%）为主，复杂损伤也达22.70%；而中老年患者中70.20%为复杂损伤。年轻患者中前十字韧带损伤（34.15%）、外侧盘状半月板（21.95%）和半月板囊肿（9.76%）的发生率较高，而中老年患者则大多伴存软骨损伤（81.25%）。结论年轻患者非创伤性半月板损伤更多发生在外侧半月板，更多伴发前十字韧带损伤、外侧盘状半月板和半月板囊肿，而中老年患者则更多发生在内侧半月板，更多伴发软骨损伤；且两组患者非创伤性半月板损伤的类型各有不同。
목적：총결불동년령단환자비창상성반월판손상적관절경하특점。방법안조납입표준：（1）MRI학진반월판III도손상，（2）차유반월판손상증상，（3）무명학급성외상사화급성증상，（4）보수치료무효，（5）재수술중학증위반월판손상。납입2012년전년전부비창상성반월판손상환자，이45세위계분위량조。술전채집기본신식、증상、체정급Lysholm평분，술중기록반월판손상적부위、류형、반발손상급수술방식。응용SPSS19.0（SPSS공사，미국）통계연건포진행통계분석，통계불동년령단환자적발병빈수，대불동년령단환자적성별、환측（좌혹우）、반월판손상류형이급반발손상정황적비교채용χ2검험。결과공납입환자201례，발병년령정쌍봉분포（20세화60세）。년경환자외측반월판손상발생비례경고（단순외측반월판손상점56.10%），이중노년환자칙상반（단순내측반월판손상점66.90%）。년경환자내측반월판손상이종행시렬（27.80%）、조취양시렬（38.90%）화수평시렬（27.80%）위주；이중노년환자칙이조취양시렬（20.60%）、수평시렬（27.20%）、근부손상（19.10%）화복잡손상（31.60%）위주。재외측반월판，년경환자이조취양시렬（45.50%）위주，복잡손상야체22.70%；이중노년환자중70.20%위복잡손상。년경환자중전십자인대손상（34.15%）、외측반상반월판（21.95%）화반월판낭종（9.76%）적발생솔교고，이중노년환자칙대다반존연골손상（81.25%）。결론년경환자비창상성반월판손상경다발생재외측반월판，경다반발전십자인대손상、외측반상반월판화반월판낭종，이중노년환자칙경다발생재내측반월판，경다반발연골손상；차량조환자비창상성반월판손상적류형각유불동。
Objective To discuss the characteristics of non?traumatic meniscus injury in patients with different age ob?served under the arthroscopy. Methods All non?traumatic meniscus injury patients operated during 2012 were included. The name, age, symptoms, signs, Lysholm score before surgery, meniscus injury location, type, and concomitant damage were collect?ed. The inclusive criteria were 1) III degree meniscus tear confirmed by MRI,2) typical symptom of meniscus injury,3) no acute symptom and history of acute injury,4) conservative treatment failed,5) and confirmed subsequently by the surgery. SPSS19.0 (SPSS Inc., USA) was used for statistical analysis. Disease frequencies were calculated for different ages in patients, and gender, disease side (left or right), the type of meniscus injury and the concomitant injury in patients of different ages were compared with the chi square test. Results All the 201 patients were divided into two groups due to whether the patients were older than 45 years. The age of surgery was bimodal distribution (20 yrs and 60 yrs). There were more lateral meniscus tears in the younger group(merely LM 56.10%), and more medial meniscus tears in the older group(merely MM 66.90%). The major type of medial meniscus tear in young patients were longitudinal(27.80%), beak sample tear(38.90%)and horizontal tear(27.80%); in old patients the main type were beak sample tear(20.60%), horizontal tear(27.20%), tear of root(19.10%)and complicated tear (31.60%). But in lateral meniscus, there were more beak sample tear(45.50%)and complicated tear(22.70%)in young pa?tients, and more than 70%were complicated tear in old patients. There were more ACL tear(34.15%), discoid lateral meniscus (21.95%)and cyst of menisci(9.76%)in young patients, but more cartilage injury(81.25%)in the old patients. Conclusion Non?traumatic meniscus tear in younger patients happened more in lateral meniscus, with more concomitant ACL tear, lateral dis?coid meniscus and cyst,but in the older group, there are more medial tear and concomitant with more cartilage injury. And the types of tear are different in the two groups.