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关节镜下前交叉韧带重建并同期半月板由内向外缝合技术在半月板桶柄样撕裂中的应用

李想 常文举 王金子 孙振越 丁海

李想, 常文举, 王金子, 孙振越, 丁海. 关节镜下前交叉韧带重建并同期半月板由内向外缝合技术在半月板桶柄样撕裂中的应用[J]. 中华全科医学, 2024, 22(9): 1508-1511. doi: 10.16766/j.cnki.issn.1674-4152.003670
引用本文: 李想, 常文举, 王金子, 孙振越, 丁海. 关节镜下前交叉韧带重建并同期半月板由内向外缝合技术在半月板桶柄样撕裂中的应用[J]. 中华全科医学, 2024, 22(9): 1508-1511. doi: 10.16766/j.cnki.issn.1674-4152.003670
LI Xiang, CHANG Wenjyu, WANG Jinzi, SUN Zhenyue, DING Hai. Efficacy of arthroscopic reconstruction of anterior cruciate ligament and simultaneous meniscus inside-out suture in the treatment of meniscus bucket handle tear[J]. Chinese Journal of General Practice, 2024, 22(9): 1508-1511. doi: 10.16766/j.cnki.issn.1674-4152.003670
Citation: LI Xiang, CHANG Wenjyu, WANG Jinzi, SUN Zhenyue, DING Hai. Efficacy of arthroscopic reconstruction of anterior cruciate ligament and simultaneous meniscus inside-out suture in the treatment of meniscus bucket handle tear[J]. Chinese Journal of General Practice, 2024, 22(9): 1508-1511. doi: 10.16766/j.cnki.issn.1674-4152.003670

关节镜下前交叉韧带重建并同期半月板由内向外缝合技术在半月板桶柄样撕裂中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003670
基金项目: 

安徽省教育厅重点项目 KJ2020A0579

详细信息
    通讯作者:

    丁海,E-mail:dinghai sjtu@163.com

  • 中图分类号: R686.5 R684

Efficacy of arthroscopic reconstruction of anterior cruciate ligament and simultaneous meniscus inside-out suture in the treatment of meniscus bucket handle tear

  • 摘要:   目的  分析半月板由内向外缝合技术在半月板桶柄样撕裂关节镜下前交叉韧带重建患者中应用效果,并与全内缝合技术比较,以促进患者术后迅速恢复,保护关节功能。  方法  回顾性分析2018年5月—2023年5月蚌埠医科大学第一附属医院收治的120例交叉韧带断裂合并内侧半月板桶柄样撕裂患者资料,患者均接受关节镜下前交叉韧带重建,依据同期半月板缝合方式将全内缝合与由内向外缝合技术患者纳入全内缝合组(51例)与内-外缝合组(69例)。比较2组患者半月板愈合率,手术时间、住院时间与手术治疗费用,手术前后三维步态参数,并发症发生率。  结果  2组半月板愈合率(90.20% vs. 94.20%,P>0.05)及手术时间、住院时间与手术治疗费用比较差异均无统计学意义;2组术后前-后位移、上-下位移、内-外位移、内-外翻以及内-外旋均下降,而屈直-伸直均上升(P<0.05),全内缝合组与内-外缝合组患者术后三维步态参数比较差异无统计学意义(P>0.05);2组患者关节间隙压痛及关节积液并发症发生率比较差异均无统计学意义(P>0.05),内-外缝合组膝内下区麻木发生率高于全内缝合组患者(13.04% vs. 0,P<0.05)。  结论  关节镜下前交叉韧带重建并同期半月板缝合采用由内向外缝合技术的疗效与全内缝合法相当,但是其术后膝内下区麻木发生率相对较高。

     

  • 图  1  全内缝合术术中

    Figure  1.  During total internal suture

    图  2  内-外缝合组

    Figure  2.  The internal external suture group

    表  1  2组交叉韧带断裂合并内侧半月板桶柄样撕裂患者半月板愈合率比较[例(%)]

    Table  1.   Comparison of meniscus healing rates between the two patient groups with cruciate ligament rupture and medial meniscus bucket handle tears [cases(%)]

    组别 例数 完全愈合 部分愈合 不愈合 半月板愈合
    全内缝合组 51 29(56.86) 17(33.34) 5(9.80) 46(90.20)
    内-外缝合组 69 34(49.28) 31(44.92) 4(5.80) 65(94.20)
    注:2组患者半月板愈合率比较,χ2=0.224,P=0.636。
    下载: 导出CSV

    表  2  2组交叉韧带断裂合并内侧半月板桶柄样撕裂患者手术时间、住院时间与手术治疗费用比较(x±s)

    Table  2.   Comparison of operation time, hospital stay, and surgical-treatment cost between the two groups of patients with cruciate ligament rupture and medial meniscus barrel handle tear(x±s)

    组别 例数 手术时间(min) 住院时间(d) 手术治疗费用(元)
    全内缝合组 51 151.90±9.28 7.67±1.23 24 289.35±1 505.04
    内-外缝合组 69 152.77±11.07 7.65±1.16 24 304.06±1 333.86
    t 0.453 0.066 0.057
    P 0.651 0.948 0.955
    下载: 导出CSV

    表  3  2组交叉韧带断裂合并内侧半月板桶柄样撕裂患者手术前后三维步态参数比较(x±s)

    Table  3.   Comparison of three-dimensional gait parameters before and after operation between the two groups of patients with cruciate ligament rupture and medial meniscus barrel handle tear(x±s)

    组别 例数 前-后位移(cm) 上-下位移(cm) 内-外位移(cm) 屈直-伸直角度(°) 内-外翻角度(°) 内-外旋角度(°)
    术前 术后 术前 术后 术前 术后 术前 术后 术前 术后 术前 术后
    全内缝合组 51 2.68±0.63 1.43±0.32b 1.89±0.63 1.52±0.51b -1.49±0.34 -1.14±0.26b 49.65±4.28 55.65±4.43b -10.36±2.57 -8.23±1.56b 18.64±2.76 15.36±1.48b
    内-外缝合组 69 2.71±0.65 1.45±0.37b 1.93±0.58 1.58±0.53b -1.51±0.36 -1.17±0.28b 49.81±4.35 55.77±4.62b -10.51±2.39 -8.38±1.62b 18.94±2.64 15.44±1.35b
    统计量 0.253a 0.119c 0.360a 0.644c 0.308a 0.953c 0.201a 0.104c 0.329a 0.287c 0.604a 0.215c
    P 0.801 0.953 0.719 0.311 0.759 0.104 0.841 0.975 0.743 0.764 0.547 0.853
    注:at值,cF值;与同组术前比较,bP<0.05。
    下载: 导出CSV

    表  4  2组交叉韧带断裂合并内侧半月板桶柄样撕裂患者并发症发生率比较[例(%)]

    Table  4.   Comparison of complication rates between the two groups of patients with cruciate ligament rupture complicated with medial meniscus barrel handle tear [cases(%)]

    组别 例数 膝内下区麻木 关节间隙压痛 关节积液
    全内缝合组 51 0 9(17.65) 10(19.61)
    内-外缝合组 69 9(13.04) 6(8.70) 6(8.70)
    χ2 5.434 2.148 3.022
    P 0.020 0.143 0.082
    下载: 导出CSV
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  • 收稿日期:  2024-01-13

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