对比关节镜下半月板成形术及半月板全切除术治疗盘状半月板损伤的临床效果。

选取2014年8月至2016年8月广东医科大学附属医院收治半月板损伤患者68例为研究对象，患者确诊为盘状半月板损伤不伴韧带松弛或损伤，单侧膝关节发病，无关节畸形及严重骨质疏松。依据术式的不同将其分为A组(25例)和B组(43例)，A组施行关节镜下全切除术，B组施行关节镜下半月板成形术。采用配对t检验和χ²检验比较两组患者Lysholm评分情况、术后3个月美国特种外科医院(HSS)评分、MRI复查情况和并发症发生情况。

两组患者术后切口均Ⅰ级愈合。A组半月板的优良率(64.00%)显著低于B组(79.06%)，差异有统计学意义(χ²＝12.84，P<0.05)。术前两组患者Lysholm评分比较，差异无统计学意义(P>0.05)；术后3个月，A组和B组患者的Lysholm评分[(77±16)分、(93±19)分]均较术前[(56±12)分、(66±14)分]显著提高(t＝4.541、5.231，P<0.05)，且B组的Lysholm评分显著高于A组，差异有统计学意义(t＝5.132，P<0.01)。B组的术后3个月膝关节评分(HSS)总分(88.0±2.3)分均明显高于对照组的(71.2±2.0)分，差异有统计学意义(t＝3.707，P<0.05)，但两组患者疼痛、肌力评分比较，差异无统计学意义(P>0.05)。MRI评估显示B组的完全愈合率高于A组，且A组发现2例有关节退行性病变。

半月板成形术及全切除术术式均具有良好的近期疗效。但半月板成形术能最大程度地恢复膝关节功能，减少膝关节退行性病变等并发症的发生，疗效优于全切除术。

To compare the clinical effects of arthroscopic menisci reformation and total meniscectomy in the treatment of discoid meniscus injuries.

Sixty-eight patients of meniscus injury were selected from August 2014 to August 2016 in the Affiliated Hospital of Guangdong Medical University, who were divided into group A (25 cases) and group B (43 cases) according to the different operation methods. Group A adopted arthroscopic total meniscectomy; group B adopted arthroscopic menisci reformation. The Lysholm score, Hospital for Special Surgery (HSS) score, MRI reexamination and complications were observed and compared by t test or χ² test between the two groups after three months.

The incision of two-group patients healed at grade I. The excellent rate of meniscus in group A (64%) was lower than that in group B (79.06%), and the difference was statistically significant (χ²=12.84, P<0.05). There was no statistically significant difference of Lysholm scores before the operation between the two groups (P>0.05); the Lysholm scores after the operation at three months in group A and group B [(77±16) and (93±19)] were all higher than those before the operation [(56±12) and (66±14)] (t=4.541, 5.231, P<0.05). The postoperoctive Lysholm score of group B was higher than that of group A, the difference was statistically significant (t=5.132, P<0.01). The total HSS scores (88.0±2.3) points in group B three months after the operation were higher than those of group A (71.2±2.0) points, the differences were all statistically significant (t=3.707, P<0.05), while there was no statistically significant difference in pain or myodynamia scores between the two groups (P>0.05). Both groups healed well, without obvious complications, such as infection or deep venous thrombosi. MRI evaluation showed that the rate of complete healing in group B was higher than that in group A, and in group A there were two cases of degenerative joint disease.

Both operation methods have good short-term effect, but menisci reformation can restore the function of knee joint to the greatest extent and reduce the complications such as degeneration of knee joint, which is better than total meniscectomy.