关节镜下同种异体半月板移植治疗半月板缺损的体会

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摘要目的探讨关节镜下同种异体半月板移植治疗半月板缺损的临床效果。方法选取2016年1月～2017年3月广州市红十字会医院骨科和深圳市第二人民医院骨科收入的15例半月板缺损患者，均行关节镜下同种异体半月板移植治疗。术后予以随访，随访内容包括关节症状及体征、膝关节影像学检查结果、膝关节Lysholm评分。结果 15例患者均获随访，随访时间8～16个月，平均（12.50±0.50）个月；93.33%患者膝关节无明显不适症状，生活能够自理，6.67%患者术后6个月关节腔出现积液并影响膝关节功能，痛感强烈，多次抽液后积液消失，疼痛得到缓解；影像学检查结果提示，93.33%患者术后膝关节间隙位无改变，周围无骨赘形成以及坏死情形发生，6.67%患者关节腔内存在少量的积液，局部存在着隆起情形；手术前后不同时间点膝关节Lysholm评分比较，差异有统计学意义（F = 6.478，P ＜ 0.05），且术后3、6、12个月均较术前提高，差异有统计学意义（P ＜ 0.05）。结论关节镜下同种异体半月板移植治疗半月板缺损临床效果较为理想，具有重要的推广使用价值。

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	王敏1 王文1 李瑛2 孟庆奇1 杨伟民1 李斯明1

关键词 ：关节镜, 同种异体半月板移植, 膝关节

Abstract：Objective To investigate the clinical efficacy of arthroscopic allogeneic meniscus transplantation in the treatment of meniscus defects. Methods Fifteen patients with meniscus defects received from the Department of Orthopedics, Guangzhou Red Cross Hospital and the Second People′s Hospital of Shenzhen from January 2016 to March 2017 were selected. All patients underwent the same allogeneic meniscus transplantation under arthroscopy. Postoperative follow-up was conducted, including joint symptoms and signs, knee imaging examination results, and Lysholm knee score. Results All the 15 patients were followed up for 8 to 16 months, with an average of (12.50±0.50) months. 93.33% of the patients had no obvious symptoms of discomfort in the knee joint and were able to take care of themselves, 6.67% of the patients developed effusion in the joint cavity 6 months after the operation, which affected the function of the knee joint. The pain was intense, and the effusion disappeared after repeated drainage, and the pain was relieved. The imaging results showed that there was no change in the postoperative knee joint space in 93.33% patients, no osteophyte formation and necrosis occurred around them, and there was a small amount of effusion in the joint cavity and local uplift in 6.67% patients. Lysholm knee score before and after surgery was compared at different time points, and the difference was statistically significant (F = 6.478 , P ＜ 0.05), and the 3, 6 months and 12 months after the operation were all improved compared with the pre-operation, the difference was statistically significant (P ＜ 0.05). Conclusion The clinical effect of allogeneic meniscus transplantation under arthroscopy for meniscus defect is better, and it has important application value.

Key words： Arthroscopy Allogeneic meniscus transplantation Knee joint

基金资助:广州市科技计划科学技术研究专项一般项目（201607010009）；
广州市医药卫生科技西医类-一般引导项目（20161A010021）。

通讯作者: 李斯明（1961.3-），男，博士，主任医师，广州市红十字会医院院长；研究方向：骨与关节软骨损伤与修复。

作者简介: 王敏（1985.12-），男，博士，广州市红十字会医院骨科教研室秘书；研究方向：关节及运动医学的损伤与修复。

引用本文:

王敏1 王文1 李瑛2 孟庆奇1 杨伟民1 李斯明1. 关节镜下同种异体半月板移植治疗半月板缺损的体会[J]. 中国医药导报, 2020, 17(3): 78-81.
WANG Min1 WANG Wen1 LI Ying2 MENG Qingqi1 YANG Weimin1 LI Siming1. Experience in the treatment of meniscus defect by allogeneic meniscus transplantation under arthroscopy. 中国医药导报, 2020, 17(3): 78-81.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I3/78

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