| Objective:"Paying equal attention to tendon and bones" theory is discussed rel atively less in terms of knee-related diseases, this subject based on the principle of "paying equal attention to tendon and bones", discusses te ndon injury-the importance of early diagnosis and treatment of Meniscus Injury. Application of arthroscopic technique to observe the extent of a rticular cartilage damage, discuss the relationship between Meniscus inju ry duration and Articular cartilage injury; To investigate the correlatio n between the Meniscus injury and knee osteoarthritis, from tendon injury to bone injury process.Methods:90 patients in accordance with the inclusion criteria with meniscus i njury from Orthopaedic Hospital of Guangzhou University of Traditional Ch inese Medicine Affiliated and Orthopedics Hospital of Guangzhou between 0 ctober 2013 and October 2014. Using the arthroscopic surgery on the patie nts; Basic preoperative assessment, recording preoperative Lysholm score; Intraoperative observations meniscal tears location, shape, the extent o f cartilage damage; Recorded separately after 3 months and 6 months posto peratively the Lysholm score. According to the different time, can be div ided into three groups.According to the time different, divided into thr ee groups, acute period group (≤2 months), total of 26 cases; subacute s tage group (2～12 months), total of 33 cases and chronic group of (>12 mo nths), total of 31 cases. At the end of the course, the changes of clinical effect were compared before and after the treatment;Compare the differen ces among the three groups of clinical efficacy and cartilage damage rati o. Grouped according to the presence of cartilage injury, compare the diff erence between two groups in the course of length.Results:1.Among the three groups of patients, the baseline data such as sex, ag e, BMI index, preoperative Lysholm score and meniscal morphology etc, the re were no statistically significant differences (P>0.05),so the three gr oups is comparable.2. Correlation between meniscal and cartilage damageThis study shows that the ratio of cartilage damage 37.78% (34 cases), and the average duration in months (21.34±23.69) than in patients wit h no cartilage injury group (7.14 ± 8.60), the difference was statistica lly significant (P<0.05)Grade Ⅰ, Ⅱ grade, Ⅲ and Ⅳ grade level in patients with cartilage damage were 5 cases (14.71%),11 cases (32.35%),13 (38.24%),5 (14.71%), with Ⅱ, Ⅲ grade main damageThree groups of cartilage injury rates were 19.23% (5 cases),39.39% (13 cases),51.61%(16 cases). Cartilage damage in chronic phase group wa s higher than the acute phase group, the difference was statistically sig nificant (P<0.017);Between chronic and sub-acute phase was no statistica lly significant difference, but its incidence is high than the latter.Cartilage and meniscal injury incidence is closely related to the cou rse, and with time and continue to increase, as more than 12 months of th eir injury rate significantly increased. After meniscal tear, age, durati on and BMI index were significantly correlatedwith the extent of cartilag e damage (P= 0.00).3. Efficacy of arthroscopic meniscal surgeryAll patients with preoperative and postoperative 3 months and 6 month s after the Lysholm scale, differences were statistically significant (P < 0.05); which Lysholm score from 60.20 ± 8.40 preoperatively, rose to 8 0.20±5.01,88.04±4.80.After three months of Lysholm score, acute group, sub-acute and chron ic phase group stage group differences among the three groups were statis tically significant (P<0.05).After operation six months of the Lysholm score between chronic with the acute phase group and sub-acute phase group differences were statisti cally significant (P<0.05);However, between acute and subacute phase gro up difference was not statistically significant. Therefore, early treatme nt can be obtained significant clinical efficacy, can significantly impro ve knee function; conversely functional improvement have different degree s of decline.Conclusions:1. The results of this study illustrate the course of meniscal tear i s closely related to articular cartilage injury incidence, when the course more than 12 months, the injury rate was significantly increased, and th erefore should be timely and accurate to treat meniscal injury. Besides t he degree of articular cartilage injury with the age, BMI index relevant.2. Preoperative clinical observation and postoperative follow-up show ed that patients with arthroscopic meniscal injury can obviously improve the clinical symptoms, signs and features, clinical curative effect affir mation.3. This study shows that meniscus injury (tendon injury) may lead to osteoarthritis (bone injury), therefore, the "tendon injury" should be pa id, active treatment; Meanwhile by arthroscopic technique to dicuss "Payi ng equal attention to tendon and bones" theory, richness and extension "P aying equal attention to tendon and bones" theory. |
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