关节镜下成形缝合术治疗完全型盘状半月板损伤的临床观察
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摘要
背景与目的：
盘状半月板(Discoid meniscus)是一种膝关节内结构的发育异常,相对少见,因半月板异常增大、增厚而近似盘状。由于盘状半月板具有异常的组织结构、畸形的形态,以及缺乏足够的血液供应而造成其极易破裂,继而引起一系列临床症状和机能的改变。盘状半月板左右两膝发病率相近,不少为双侧同时发病,外侧多见,内侧罕见,且发病多为青壮年。其分为三种类型：完全型、不完全型、Wrisberg韧带型,根据临床特征及MRI表现可确诊。对损伤的盘状半月板诊断确定后,唯一可靠的治疗方法是手术治疗,以解除关节活动障碍,预防和减少创伤性关节炎的发生。完全型盘状半月板在形态上完全为圆盘状,内侧部分存在,厚而大,半月板的外援和内缘厚度相差不大,从而将整个股骨和胫骨平台隔开。完全型盘状半月板损伤后,往往会出现层状裂,常合并有其他部位撕裂,少数严重者伴有前角和(或)后角断裂。治疗完全型盘状半月板的损伤,一般成形术不能完全消除其体征而又缝合困难,治疗较为复杂,是盘状半月板损伤治疗中的一个难题。在既往临床实践中,对于完全型盘状半月板的损伤一般采用关节镜下全切除术,术后早期患者的症状可得到缓解,膝关节的功能得到有效改善。但全切术会使关节不稳定且加速软骨的退变,远期甚至会造成骨性关节炎的出现。随着医疗水平的提高、医疗技术的发展,关节镜下成形、缝合术逐渐代替了全切除术。
我们探讨在关节镜下施行成形、缝合的方法治疗完全型盘状半月板损伤的临床疗效。关节镜下成形、缝合修复术不仅能最大程度的保留了半月板的生物学功能,使膝关节力学接近正常,且近期的治疗效果也令人满意。关节镜下成形、缝合术是治疗完全型盘状半月板损伤的一种有效方法。
研究对象与方法：
选取郑州大学第一附属医院骨科2007年6月至2012年6月收治的56例完全型膝关节盘状半月板损伤患者,根据患者对手术方式的不同选择分为两组。Ⅰ组(实验组),28例患者行关节镜下成形、缝合的手术治疗；男16例,女12例；年龄3-28岁,平均17岁；右膝14例,左膝14例。Ⅱ组(对照组),28例患者行关节镜下全切除术治疗；男15例,女13例；年龄4～29岁,平均17岁；右膝11例,左膝17例。两组患者在年龄、性别、临床症状等方面在统计学上无差异。所有患者均为完全型外侧盘状半月板损伤,均有膝关节内疼痛,Mcmurray征均为阳性；Ⅰ组27例出现关节弹响,26例有继发性关节内别卡感,15例出现关节肿胀,6例有膝关节伸直功能受限,5例有过屈疼,4例有股四头肌萎缩,1例出现跛行；Ⅱ组28例出现关节弹响,27例有继发性关节内别卡感,13例出现关节肿胀,7例有膝关节伸直功能受限,6例有过屈疼,3例有股四头肌萎缩,1例出现跛行。术后随访8-16月,平均12月。了解患者的疼痛,弹响,交锁,肿胀,活动度及患肢整体功能康复情况,通过Lysholm评分系统评价膝关节功能,对手术疗效进行分析。统计资料应用SPSS16.0统计分析软件进行处理。
结果：
术中关节镜探查均证实为完全型盘状半月板损伤。Ⅰ组：全膝关节滑膜严重增生6例,半月板前部层状裂9例,外后部层状裂10例,完全层状裂9例,桶柄状撕裂6例,前角撕裂7例,后角撕裂5例,前后角均断裂10例；Ⅱ组：全膝关节滑膜严重增生8例,半月板前部层状裂8例,外后部层状裂11例,完全层状裂9例,桶柄状撕裂7例,前角撕裂5例,后角撕裂6例,前后角均断裂11例。两组患者关节镜下探查的半月板损伤情况在统计学上无差异。56例患者均获得随访,术后3个月随访,行关节镜下成形、缝合术的28例患者,3例发生轻度肿胀,3例有关节内不适感,1例发生轻度关节内疼痛,5例膝关节活动受限,于随访时行局麻下手法松解,并用CPM机进行膝关节功能恢复锻炼,2例出现股四头肌萎缩；行关节镜下全切除术的28例患者,4例发生轻度肿胀,2例发生轻度关节内疼痛,1例出现股四头肌萎缩,无患者出现膝关节活动受限及关节内不适感。末次随访,行关节镜下成形、缝合术的28例患者,1例发生轻度肿胀,1例有关节内不适感,1例发生轻度关节内疼痛,无患者出现膝关节活动受限及股四头肌萎缩；行关节镜下全切除术的28例患者,1例发生轻度肿胀,2例发生轻度关节内疼痛,无患者出现出现股四头肌萎缩、膝关节活动受限及关节内不适感；所有患者膝关节活动度均达到110度左右。行关节镜下成形、缝合术的28例患者的Lysholm评分由术前的45.21±3.91提高到术后3个月的82.93±2.54、术后6个月的90.75±2.66、术后12个月的91.32±2.87,行关节镜下全切除术的28例患者的Lysholm评分由术前的45.89±3.54提高到术后3个月的90.64±2.64、术后6个月的90.89±2.56、术后12个月的91.14±2.49。运用SPSS16.0软件采用配对t检验进行分析,关节镜下成形、缝合术与关节镜下全切除术在术前比较,p值>0.05,无差异；术后3个月p值<0.05,有差异；术后6个月、12个月p值均>0.05,无差异。横向比较中,采用单因素方差分析,在术式1中术后6个月与术后12个月的差异无差异(P=0.484),其余两两比较均具有差异。在术式2中,术后3个月、6个月、12个月两两比较均无差异(P=0.743,P=-0.743,P=0.511),与术前比较均具有差异。
结论：
与传统的关节镜下盘状半月板全切除术相比,关节镜下成形、缝合术不但在近期内膝关节术后整体的功能恢复令人满意,而且避免了膝关节因传统手术方法造成的生物学改变,是治疗完全型盘状半月板损伤的一种有效的方法。
Background and objective
Discoid meniscus is a rare dysplasia of the internal structures of the joint, which is named for the meniscus is thickened and enlarged to be discoid abnormally to a disk shape.And it is easy to rupture caused by the anomalous structural tissue, deformities and the blood supply lacking. At the same time, meniscus will also lead to a lot of clinical symptoms and function changes.The incidence of the two knees are similar, and the attack is usually in bilateral. When the dysplasia happens,the lateral one is common while the interior one is rare, and the teenagers are always the high risk group. Discoid meniscus can be divided into three types, complete type of discoid meniscus, incomplete type and Wrisberg ligament type. They can be diagnosed based on the clinic characteristics and MRI. After the final diagnosis of injury discoid meniscus, surgical treatment is the only reliable method to avoid the joint mobility and decreasing the occurrence of traumatic arthritis. The complete type of discoid meniscus is actually a disc, and the inside part where is big and fat is existing and the thickness of its inner and outer side have little difference so that can make a separation of the femur and tibia. The layer-crack would usually happen after the complete type of discoid meniscus got injury with the tear of the other part. What is worse, there were a few cases in which the patients got the rupture on front and back rake. The complete type of discoid meniscus injury is a problem during the treatment. And the discoid meniscus injury is the common angioplasty which could not remove the clinical symbols and could be stitched difficultly. And it always refers to the discoid meniscus (DM) which is complete in front but lamina tearing in the middle and back. At the same time, the breakage would happen in the ventral horn and(or) the dorsal horn,with the tearing in the other sites.According to the formal clinic practice, Arthroscopy has been the most optimal therapy for the injury of discoid meniscus and can benefit the knee joint. However, it will cause unstable of joint and also will speed up the degeneration of the cartilage. What is worse, it will cause the osteoarthritis. Thus with the development and improvement of the medical technology, the arthroscopic meniscoplasty combined with menascorrhaphy would take the place of the subtotal resection.
We explore the result of the meniscoplasty combined with menascorrhaphy under the arthroscope to treat discoid meniscus. This kind of treatment which is under arthroscope can not only keep the biological function of the meniscus to the best,but also can make knee mechanics restored to normal, and the the clinical outcome reach to satisfaction. Thus, arthroscopic meniscoplasty Combined with menascorrhaphy to treat discoid meniscus is an effective one to treat the discoid meniscus.
Objects and methods
A total of56complete type of injury discoid meniscus patients that had been treated with of symptomatic treatment in the orthopedics in First Affiliated Hospital, Zhengzhou University from July2007to July2012. Based on the surgery options, these patients are divided into2groups, which are experiment group and control group. In group Ⅰ(experiment group), there are28patients were operated by angioplasty with neoplasty and suture repair under the arthroscope and the number of male is16, and female is12, the age range3to28, the average age is18. And14right knees cases and14left were involved. Then the other28patients in group Ⅱ(control group), volunteered to get the subtotal resection. Those patients include15males and 13females. The mean age was17(range4-29years).11of the patients happened on right knee and17on the left.The patients from different group have the differences on age, gender, symptoms and so on. All of them were all lateral discoid meniscus and the patients all got pain in intra-knee as well. At the same time, the Mcmurray signs of them all read positive.Beside that,27of them are snapping, and there are26of them got the secondary interlocking,15of them got the ankle swelling,6were restricted with their extense function of knee joint,6felt pain when bent,3patients had quadriceps femoral's atrophic and1lameness were noted in the case in group I. The patients were followed up for8to16months; a mean time was12month. The patients were evaluated for pain, swelling, snap, interlock, activities and rehabilitation of the patients. Observe the postoperative short-term curative effect which was evaluated by Lysholm and IKDC. The result of the surgical treatment is analyzed. The statistics are processed by statistical analysis software SPSS16.0.
Results
All56patients were successfully be followed up, and all patients were diagnosed as having discoid meniscus. Among the patients in group I, there were6patients' knee joint synovial got terrible hyperplasia, front layer crack of the meniscus happened on9cases, and10patients got the layer crack on the outer-rear meniscus, and9patiences got complete crack. Beside that,the number of barrels pie tear is6,anterior angle tear is7and relief angle is5and both anterior and relief is10in group I. There were8patients' knee joint synovial got terrible hyperplasia, front layer crack of the meniscus happened on8cases, and11patients got the layer crack on the outer-rear meniscus, and9patiences got complete crack. The number of barrels pie tear is7, anterior angle tear is5and relief angle is6and both anterior and relief is11in group II. There's no statistical difference between experiment group and control group observing the injury situation under the arthroscope. When had follow-up visit3month after the surgery, the28patients who were operated by meniscoplasty combined with menascorrhaphy under arthroscope to treat discoid meniscus, there were slight pain and discomfort in1cases and swelling in3cases, knee joint motivation limitation in5cases, Then the patient was relaxed by anesthesia, at the same time,the CPM was used for the functional exercise of knee joint to get recovery. Also2case was noted by quadriceps femoral's atrophic. Meanwhile,28patients who got the subtotal resection,there were2having slight space pain on knee joint,4were swell, one quadriceps femoral's atrophic and no patients got the move limitation or discomfort in the knee joint. The last follow-up, the28patients who were operated by arthroscopic meniscoplasty combined with menascorrhaphy to treat discoid meniscus, there were slight pain and discomfort and swelling in1cases, no patients was noted by knee joint motivation limitation and quadriceps femoral's atrophic. As to the other28patients who got the subtotal resection, there was one cases on slight swelling and2cases on joint pain, no patients got the quadriceps femoral's atrophic,move limitation or discomfort in the knee joint. All the patients' activities reach110. For the patients who were operated by meniscoplasty combined with menascorrhaphy under arthroscope to treat discoid meniscus, the Lysholm scores ascended from (45.21±3.91) to (82.93±2.54)3months after the surgery, and (90.75±2.66)6months later,(91.32±2.87)12months later. For the patients who took the subtotal resection, the Lysholm scores ascended from (45.89±3.54) to (90.64±2.64)3months after the surgery, and (90.89±2.56)6months later,(91.14±2.49)12months later. Using SPSS16.0software by matching1test analysis, arthroscopic neoplasty and suture, P>0.05with no difference before the surgery and P<0.05with a difference3months after the surgery; P>0.05with no difference6and12months after the surgery. To make a comparative single factor variance analysis, for the first kind of surgery,6months and12months later surgery have no difference (P=0.484). Differences of the first surgery and the second surgery were found between groups. In the second surgery, there is no difference in two groups among3,6,12months later the surgery (P=0.743, P=0.143, P=0.511). If compare with the pre-surgery, there is difference
Conclusion
Compared with the traditionary the subtotal resection, arthroscopic surgery for neoplasty and suture can improve the knee function effectively and alleviate symptom obviously. It is a good way to recover the knees with fewer traumas, faster recovery, and lower cost to treat the complete type of discoid meniscus.The result of knee flexibility improvement and the recovery of the whole function satisfy people in the early time after surgery and also can avoid the biology change of the knees that caused by the traditional surgery. Thus, it is regarded as the effective treatment of the complete type of discoid meniscus.
盘状半月板(Discoid meniscus)是一种膝关节内结构的发育异常,相对少见,因半月板异常增大、增厚而近似盘状。由于盘状半月板具有异常的组织结构、畸形的形态,以及缺乏足够的血液供应而造成其极易破裂,继而引起一系列临床症状和机能的改变。盘状半月板左右两膝发病率相近,不少为双侧同时发病,外侧多见,内侧罕见,且发病多为青壮年。其分为三种类型：完全型、不完全型、Wrisberg韧带型,根据临床特征及MRI表现可确诊。对损伤的盘状半月板诊断确定后,唯一可靠的治疗方法是手术治疗,以解除关节活动障碍,预防和减少创伤性关节炎的发生。完全型盘状半月板在形态上完全为圆盘状,内侧部分存在,厚而大,半月板的外援和内缘厚度相差不大,从而将整个股骨和胫骨平台隔开。完全型盘状半月板损伤后,往往会出现层状裂,常合并有其他部位撕裂,少数严重者伴有前角和(或)后角断裂。治疗完全型盘状半月板的损伤,一般成形术不能完全消除其体征而又缝合困难,治疗较为复杂,是盘状半月板损伤治疗中的一个难题。在既往临床实践中,对于完全型盘状半月板的损伤一般采用关节镜下全切除术,术后早期患者的症状可得到缓解,膝关节的功能得到有效改善。但全切术会使关节不稳定且加速软骨的退变,远期甚至会造成骨性关节炎的出现。随着医疗水平的提高、医疗技术的发展,关节镜下成形、缝合术逐渐代替了全切除术。
我们探讨在关节镜下施行成形、缝合的方法治疗完全型盘状半月板损伤的临床疗效。关节镜下成形、缝合修复术不仅能最大程度的保留了半月板的生物学功能,使膝关节力学接近正常,且近期的治疗效果也令人满意。关节镜下成形、缝合术是治疗完全型盘状半月板损伤的一种有效方法。
研究对象与方法：
选取郑州大学第一附属医院骨科2007年6月至2012年6月收治的56例完全型膝关节盘状半月板损伤患者,根据患者对手术方式的不同选择分为两组。Ⅰ组(实验组),28例患者行关节镜下成形、缝合的手术治疗；男16例,女12例；年龄3-28岁,平均17岁；右膝14例,左膝14例。Ⅱ组(对照组),28例患者行关节镜下全切除术治疗；男15例,女13例；年龄4～29岁,平均17岁；右膝11例,左膝17例。两组患者在年龄、性别、临床症状等方面在统计学上无差异。所有患者均为完全型外侧盘状半月板损伤,均有膝关节内疼痛,Mcmurray征均为阳性；Ⅰ组27例出现关节弹响,26例有继发性关节内别卡感,15例出现关节肿胀,6例有膝关节伸直功能受限,5例有过屈疼,4例有股四头肌萎缩,1例出现跛行；Ⅱ组28例出现关节弹响,27例有继发性关节内别卡感,13例出现关节肿胀,7例有膝关节伸直功能受限,6例有过屈疼,3例有股四头肌萎缩,1例出现跛行。术后随访8-16月,平均12月。了解患者的疼痛,弹响,交锁,肿胀,活动度及患肢整体功能康复情况,通过Lysholm评分系统评价膝关节功能,对手术疗效进行分析。统计资料应用SPSS16.0统计分析软件进行处理。
结果：
术中关节镜探查均证实为完全型盘状半月板损伤。Ⅰ组：全膝关节滑膜严重增生6例,半月板前部层状裂9例,外后部层状裂10例,完全层状裂9例,桶柄状撕裂6例,前角撕裂7例,后角撕裂5例,前后角均断裂10例；Ⅱ组：全膝关节滑膜严重增生8例,半月板前部层状裂8例,外后部层状裂11例,完全层状裂9例,桶柄状撕裂7例,前角撕裂5例,后角撕裂6例,前后角均断裂11例。两组患者关节镜下探查的半月板损伤情况在统计学上无差异。56例患者均获得随访,术后3个月随访,行关节镜下成形、缝合术的28例患者,3例发生轻度肿胀,3例有关节内不适感,1例发生轻度关节内疼痛,5例膝关节活动受限,于随访时行局麻下手法松解,并用CPM机进行膝关节功能恢复锻炼,2例出现股四头肌萎缩；行关节镜下全切除术的28例患者,4例发生轻度肿胀,2例发生轻度关节内疼痛,1例出现股四头肌萎缩,无患者出现膝关节活动受限及关节内不适感。末次随访,行关节镜下成形、缝合术的28例患者,1例发生轻度肿胀,1例有关节内不适感,1例发生轻度关节内疼痛,无患者出现膝关节活动受限及股四头肌萎缩；行关节镜下全切除术的28例患者,1例发生轻度肿胀,2例发生轻度关节内疼痛,无患者出现出现股四头肌萎缩、膝关节活动受限及关节内不适感；所有患者膝关节活动度均达到110度左右。行关节镜下成形、缝合术的28例患者的Lysholm评分由术前的45.21±3.91提高到术后3个月的82.93±2.54、术后6个月的90.75±2.66、术后12个月的91.32±2.87,行关节镜下全切除术的28例患者的Lysholm评分由术前的45.89±3.54提高到术后3个月的90.64±2.64、术后6个月的90.89±2.56、术后12个月的91.14±2.49。运用SPSS16.0软件采用配对t检验进行分析,关节镜下成形、缝合术与关节镜下全切除术在术前比较,p值>0.05,无差异；术后3个月p值<0.05,有差异；术后6个月、12个月p值均>0.05,无差异。横向比较中,采用单因素方差分析,在术式1中术后6个月与术后12个月的差异无差异(P=0.484),其余两两比较均具有差异。在术式2中,术后3个月、6个月、12个月两两比较均无差异(P=0.743,P=-0.743,P=0.511),与术前比较均具有差异。
结论：
与传统的关节镜下盘状半月板全切除术相比,关节镜下成形、缝合术不但在近期内膝关节术后整体的功能恢复令人满意,而且避免了膝关节因传统手术方法造成的生物学改变,是治疗完全型盘状半月板损伤的一种有效的方法。
Background and objective
Discoid meniscus is a rare dysplasia of the internal structures of the joint, which is named for the meniscus is thickened and enlarged to be discoid abnormally to a disk shape.And it is easy to rupture caused by the anomalous structural tissue, deformities and the blood supply lacking. At the same time, meniscus will also lead to a lot of clinical symptoms and function changes.The incidence of the two knees are similar, and the attack is usually in bilateral. When the dysplasia happens,the lateral one is common while the interior one is rare, and the teenagers are always the high risk group. Discoid meniscus can be divided into three types, complete type of discoid meniscus, incomplete type and Wrisberg ligament type. They can be diagnosed based on the clinic characteristics and MRI. After the final diagnosis of injury discoid meniscus, surgical treatment is the only reliable method to avoid the joint mobility and decreasing the occurrence of traumatic arthritis. The complete type of discoid meniscus is actually a disc, and the inside part where is big and fat is existing and the thickness of its inner and outer side have little difference so that can make a separation of the femur and tibia. The layer-crack would usually happen after the complete type of discoid meniscus got injury with the tear of the other part. What is worse, there were a few cases in which the patients got the rupture on front and back rake. The complete type of discoid meniscus injury is a problem during the treatment. And the discoid meniscus injury is the common angioplasty which could not remove the clinical symbols and could be stitched difficultly. And it always refers to the discoid meniscus (DM) which is complete in front but lamina tearing in the middle and back. At the same time, the breakage would happen in the ventral horn and(or) the dorsal horn,with the tearing in the other sites.According to the formal clinic practice, Arthroscopy has been the most optimal therapy for the injury of discoid meniscus and can benefit the knee joint. However, it will cause unstable of joint and also will speed up the degeneration of the cartilage. What is worse, it will cause the osteoarthritis. Thus with the development and improvement of the medical technology, the arthroscopic meniscoplasty combined with menascorrhaphy would take the place of the subtotal resection.
We explore the result of the meniscoplasty combined with menascorrhaphy under the arthroscope to treat discoid meniscus. This kind of treatment which is under arthroscope can not only keep the biological function of the meniscus to the best,but also can make knee mechanics restored to normal, and the the clinical outcome reach to satisfaction. Thus, arthroscopic meniscoplasty Combined with menascorrhaphy to treat discoid meniscus is an effective one to treat the discoid meniscus.
Objects and methods
A total of56complete type of injury discoid meniscus patients that had been treated with of symptomatic treatment in the orthopedics in First Affiliated Hospital, Zhengzhou University from July2007to July2012. Based on the surgery options, these patients are divided into2groups, which are experiment group and control group. In group Ⅰ(experiment group), there are28patients were operated by angioplasty with neoplasty and suture repair under the arthroscope and the number of male is16, and female is12, the age range3to28, the average age is18. And14right knees cases and14left were involved. Then the other28patients in group Ⅱ(control group), volunteered to get the subtotal resection. Those patients include15males and 13females. The mean age was17(range4-29years).11of the patients happened on right knee and17on the left.The patients from different group have the differences on age, gender, symptoms and so on. All of them were all lateral discoid meniscus and the patients all got pain in intra-knee as well. At the same time, the Mcmurray signs of them all read positive.Beside that,27of them are snapping, and there are26of them got the secondary interlocking,15of them got the ankle swelling,6were restricted with their extense function of knee joint,6felt pain when bent,3patients had quadriceps femoral's atrophic and1lameness were noted in the case in group I. The patients were followed up for8to16months; a mean time was12month. The patients were evaluated for pain, swelling, snap, interlock, activities and rehabilitation of the patients. Observe the postoperative short-term curative effect which was evaluated by Lysholm and IKDC. The result of the surgical treatment is analyzed. The statistics are processed by statistical analysis software SPSS16.0.
Results
All56patients were successfully be followed up, and all patients were diagnosed as having discoid meniscus. Among the patients in group I, there were6patients' knee joint synovial got terrible hyperplasia, front layer crack of the meniscus happened on9cases, and10patients got the layer crack on the outer-rear meniscus, and9patiences got complete crack. Beside that,the number of barrels pie tear is6,anterior angle tear is7and relief angle is5and both anterior and relief is10in group I. There were8patients' knee joint synovial got terrible hyperplasia, front layer crack of the meniscus happened on8cases, and11patients got the layer crack on the outer-rear meniscus, and9patiences got complete crack. The number of barrels pie tear is7, anterior angle tear is5and relief angle is6and both anterior and relief is11in group II. There's no statistical difference between experiment group and control group observing the injury situation under the arthroscope. When had follow-up visit3month after the surgery, the28patients who were operated by meniscoplasty combined with menascorrhaphy under arthroscope to treat discoid meniscus, there were slight pain and discomfort in1cases and swelling in3cases, knee joint motivation limitation in5cases, Then the patient was relaxed by anesthesia, at the same time,the CPM was used for the functional exercise of knee joint to get recovery. Also2case was noted by quadriceps femoral's atrophic. Meanwhile,28patients who got the subtotal resection,there were2having slight space pain on knee joint,4were swell, one quadriceps femoral's atrophic and no patients got the move limitation or discomfort in the knee joint. The last follow-up, the28patients who were operated by arthroscopic meniscoplasty combined with menascorrhaphy to treat discoid meniscus, there were slight pain and discomfort and swelling in1cases, no patients was noted by knee joint motivation limitation and quadriceps femoral's atrophic. As to the other28patients who got the subtotal resection, there was one cases on slight swelling and2cases on joint pain, no patients got the quadriceps femoral's atrophic,move limitation or discomfort in the knee joint. All the patients' activities reach110. For the patients who were operated by meniscoplasty combined with menascorrhaphy under arthroscope to treat discoid meniscus, the Lysholm scores ascended from (45.21±3.91) to (82.93±2.54)3months after the surgery, and (90.75±2.66)6months later,(91.32±2.87)12months later. For the patients who took the subtotal resection, the Lysholm scores ascended from (45.89±3.54) to (90.64±2.64)3months after the surgery, and (90.89±2.56)6months later,(91.14±2.49)12months later. Using SPSS16.0software by matching1test analysis, arthroscopic neoplasty and suture, P>0.05with no difference before the surgery and P<0.05with a difference3months after the surgery; P>0.05with no difference6and12months after the surgery. To make a comparative single factor variance analysis, for the first kind of surgery,6months and12months later surgery have no difference (P=0.484). Differences of the first surgery and the second surgery were found between groups. In the second surgery, there is no difference in two groups among3,6,12months later the surgery (P=0.743, P=0.143, P=0.511). If compare with the pre-surgery, there is difference
Conclusion
Compared with the traditionary the subtotal resection, arthroscopic surgery for neoplasty and suture can improve the knee function effectively and alleviate symptom obviously. It is a good way to recover the knees with fewer traumas, faster recovery, and lower cost to treat the complete type of discoid meniscus.The result of knee flexibility improvement and the recovery of the whole function satisfy people in the early time after surgery and also can avoid the biology change of the knees that caused by the traditional surgery. Thus, it is regarded as the effective treatment of the complete type of discoid meniscus.
引文
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