| Objective: To compare the short-term and medium-term effects of arthroscopic meniscal suture and partial excision in the treatment of meniscal injury.Methods: From September 2016 to December 2018,86 patients with meniscusⅢ ° injury who were treated by arthroscopic suture or partial resection in the Department of orthopaedics II,Affiliated Hospital of Hebei University of engineering were studied retrospectively,including 42 patients in the arthroscopic suture group and 44 patients in the arthroscopic partial resection group.According to the preoperative physical examination and MRI,meniscal injury of Ⅲ ° has been clearly diagnosed.All of the above 86 patients were followed up after operation.After the operation,the detailed rehabilitation training plan was made according to the patients’ own physiological conditions,and the X-ray or MRI reexamination of the positive and lateral position of the knee joint was given regularly to evaluate the functional recovery of the knee joint.After 12 months follow-up,Lysholm score and IKDC score were used to evaluate the knee joint function subjectively.According to Barrett’s criteria of meniscus healing,the healing status of meniscus after arthroscopic suture was evaluated.The related evaluation indexes include: VAS score,joint space change,articular cartilage degeneration degree and joint flexion and extension activity degree.According to the results of follow-up,we analyzed and compared the relationship between suture and partial excision in the treatment of meniscal injury.Results:86 patients were followed up for 10-12 months(mean 11.43 ± 0.68months).The end point of follow-up was death and loss of follow-up value.According to the physical examination and Barrett evaluation criteria during the last follow-up,the clinical healing rate of the suture group was 95.2%,and that of the partial resection group was 81.8%.12 months after operation,the incidence of joint space stenosis and articular cartilage degeneration was 7.14% in suture group and11.36% in partial resection group.There was no significant difference between the two groups(P > 0.05).Lysholm score: the suture group increased from 40.3 ± 21.2points before operation to 87.1 ± 17.4 points after operation(P < 0.05),excellent in 16 cases,good in 19 cases,good in 83.3%,the difference was statistically significant;partial resection group increased from 41.4 ± 16.7 points before operation to 82.5 ±17.3 points after operation(P < 0.05),excellent in 13 cases,good in 21 cases,good in77.3%,the difference was statistically significant.IKDC score: the suture group increased from 45.3 ± 17.8 points before operation to 86.4 ± 17.2 points after operation,the partial resection group increased from 45.5 ± 17.3 points before operation to 83.6 ± 17.1 points after operation,P < 0.05,the difference was statistically significant.VAS score: the difference was statistically significant in suture group from 3.0 ± 1.2 before operation to 1.2 ± 0.8 after operation(P < 0.05);the difference was statistically significant in partial resection group from 2.6 ± 1.5 before operation to 1.4 ± 1.1 after operation(P < 0.05);there was no statistically significant difference in VAS score between two groups after operation and before operation(P >0.05).The flexion and extension activity of knee joint: the suture group increased from 120.75 ± 10.45 ° before operation to 130.48 ± 13.62 ° after operation;the partial resection group increased from 120.38 ± 9.65 ° before operation to 125.87 ± 10.58 °after operation;the difference between the two groups was statistically significant(P< 0.05).Conclusions: Arthroscopic suture and partial resection have certain curative effect in the treatment of meniscus III ° injury.In terms of improving knee joint function,joint flexion and extension activity and clinical healing rate,the curative effect of suture is better than that of partial resection,while in the incidence of joint space stenosis and the incidence of articular cartilage degeneration,the two methods have the same effect. |
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