Efficacy observation and imaging evaluation of arthroscopic repair of degenerative medial meniscus injury in middle-aged and elderly patients
10.3969/j.issn.1671-8348.2023.23.018
- VernacularTitle:关节镜修补中老年退变性内侧半月板损伤的疗效观察及影像学评估
- Author:
Zhenfei LU
1
;
Lei LIU
;
Pengfei JIA
;
Hongxia ZHOU
;
Jianhua WANG
Author Information
1. 南京中医药大学无锡附属医院运动医学科/江苏省中医退行性骨关节病临床医学创新中心,江苏无锡 214000
- Keywords:
degenerative medial meniscus injury;
arthroscopic meniscus repair;
meniscus injury heal-ing;
magnetic resonance imagine
- From:
Chongqing Medicine
2023;52(23):3620-3625,3631
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical effect of arthroscopic repair of isolated degenerative medi-al meniscus injury in patients over 45 years old and to evaluate the healing after more than two years of fol-low-up through MRI.Methods A retrospective study was conducted on the clinical effects of 51 patients with isolated degenerative medial meniscus injury who underwent arthroscopic repair from January 2016 to Decem-ber 2020.The meniscus was sutured by total internal suture or total internal suture combined with internal-to-external technique.IKDC score,Tegner score and Lysholm score were recorded before operation and at the last follow-up(at least 24 months).The type and location of meniscus injury during operation,and the microscopic classification and location of cartilage injury were recorded.At the same time,MRI was used to observe the healing of meniscus and ICRS cartilage injury grading.On MRI,0-2 degree injury was defined as meniscus healing,and 3 degree injury was defined as nonunion.The clinical repair failure was judged according to the Barrett evaluation criteria.Results The average age of the patients was(57.3±8.4)years,and the average follow-up time was(55.0±15.3)months.There were 47.1％complex fissures,31.3％horizontal fissures and 21.6％other types.The Lysholm score increased from 53.5±6.4 preoperative to 87.6±7.9 postoperative,the IKDC score increased from 33.6±4.7 preoperative to 72.8±5.3 postoperative,and the Tegner score increased from 1.0±0.1 preoperative to 4.0±0.5 postoperative.Three patients were judged as clinical repair failure,and five patients had progressed cartilage injury after surgery.At the last follow-up,the meniscus healing was observed on MRI:0 degree in two cases(3.9％),1 degree in 17 cases(33.3％),2 degree in 11 cases(21.6％),3 degree in 21 cases(41.2％).Conclusion For middle-aged and elderly patients with isolated de-generative medial meniscus injury,if conservative treatment is not effective or there are mechanical obstruc-tion factors,arthroscopic meniscus repair can achieve good clinical results and low clinical repair failure rate.
