CAJ | 학술논문

目的：探讨关节镜下止点重建治疗膝关节外侧半月板后根部撕裂的临床效果。方法2010年3月至2014年3月，18例膝关节外侧半月板后根部损伤患者接受关节镜手术治疗。其中单纯后根部损伤7例，后根联合体部放射状撕裂11例，18例中15例合并前交叉韧带( anterior cruciate ligament，ACL )损伤、3例合并多发韧带损伤者均一期重建。患者术前、术后进行膝关节主观功能评分测定，包括 Lysholm 评分、IKDC 评分、( visual analog scale，VAS )疼痛评分。对随访患者进行 MRI 检查及二次关节镜探查了解外侧半月板损伤愈合情况。结果18例随访6～41个月，平均20.2个月。患者术后膝关节 Lysholm 评分为90.0±4.5、IKDC 评分为84.6±3.2、VAS 疼痛评分为0.7±0.9，与术前比较，差异有统计学意义(P＜0.001)。18例于术后1年接受 MRI 检查，17例显示完全愈合，愈合率为94.4%。18例接受二次关节镜检查，外侧半月板损伤完全愈合，愈合率为100%。结论通过关节镜下止点重建治疗膝关节外侧半月板后根部撕裂的观察，更有利于对该区域的半月板损伤进行全内修复缝合，患者术后早期膝关节功能评分满意。
목적：탐토관절경하지점중건치료슬관절외측반월판후근부시렬적림상효과。방법2010년3월지2014년3월，18례슬관절외측반월판후근부손상환자접수관절경수술치료。기중단순후근부손상7례，후근연합체부방사상시렬11례，18례중15례합병전교차인대( anterior cruciate ligament，ACL )손상、3례합병다발인대손상자균일기중건。환자술전、술후진행슬관절주관공능평분측정，포괄 Lysholm 평분、IKDC 평분、( visual analog scale，VAS )동통평분。대수방환자진행 MRI 검사급이차관절경탐사료해외측반월판손상유합정황。결과18례수방6～41개월，평균20.2개월。환자술후슬관절 Lysholm 평분위90.0±4.5、IKDC 평분위84.6±3.2、VAS 동통평분위0.7±0.9，여술전비교，차이유통계학의의(P＜0.001)。18례우술후1년접수 MRI 검사，17례현시완전유합，유합솔위94.4%。18례접수이차관절경검사，외측반월판손상완전유합，유합솔위100%。결론통과관절경하지점중건치료슬관절외측반월판후근부시렬적관찰，경유리우대해구역적반월판손상진행전내수복봉합，환자술후조기슬관절공능평분만의。
Objective To evaluate clinical outcomes of arthroscopic ending reconstruction of posterior root tear of the lateral meniscus in the knee.Methods From March 2010 to March 2014, 18 cases of posterior root tear of the lateral meniscus in the knee underwent arthroscopic ending reconstruction. Seven cases were of simple tear of the root, 11 were of combined radial tear of the posterior lateral complex. Fifteen cases combined with anterior cruciate ligament ( ACL ) injury and 3 cases with multiple ligaments injury underwent one-stage reconstruction. Lysholm score, IKDC score and visual analog scale ( VAS ) were applied to evaluate knee functions preoperatively and postoperatively. MRI and arthroscopic exploration of patients with follow-up were used to evaluate the healing of the lateral meniscus tear.Results The mean follow-up period was 20.2 months ( range: 6-41 months ). Postoperatively, the Lysholm knee score was 90.0±4.5, IKDC knee score was 84.6±3.2, VAS knee score was 0.7±0.9. Differences were statistically significant (P<0.001 ). Eighteen cases received MRI examination 1 year postoperatively: 17 cases ( healing rate: 94.4% ) showed completely healing of the meniscus and 18 cases ( healing rate: 100% ) with cruciate ligaments injury were conifrmed completely healing of the lateral meniscus by arthroscopic exploration.Conclusions Arthroscopic ending reconstruction is a good option in the treatment of posterior root tears of the lateral meniscus in the knee with the advantage of complete internal suture and reconstruction. It can receive satisfactory knee functions.