[儿童和青少年半月板修复术的临床结果和并发症]。

Acta ortopedica mexicana Pub Date : 2023-11-01
F Pauletti, M Carabajal-Mattar, L Marangoni, J J Masquijo
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引用次数: 0

摘要

导言:关于半月板修复术在儿科人群中的应用效果,目前还鲜有相关资料。本研究旨在评估半月板修复术在前交叉韧带断裂和盘状半月板不稳定病变的孤立性病变儿科人群中的临床效果和并发症。材料和方法:对78名18岁、经关节镜诊断为孤立性半月板病变、伴有前交叉韧带撕裂或盘状半月板的患者进行了关节镜修复术,并对其人口统计学特征、手术技术和围手术期并发症进行了回顾性分析。功能结果采用 Lysholm 和 Pedi-IKDC 量表进行评估。修复失败时间定义为半月板修复与翻修(再次修复或半月板次全切除术)之间的间隔时间。C组患者明显更年轻(A组15.4岁 vs B组14.9岁 vs C组12.1岁,P = 0.001)。平均随访时间为 33.8 个月。Lysholm 评分和 Pedi-IKDC 平均值分别为 96.1 分(范围为 76-100 分)和 93.8 分(范围为 59.8-100 分)。总体失败率为 14.1%(11/78)。A 组有 4 例(13%)失败,B 组有 3 例(12%)失败,C 组有 5 例(17%)失败(P = 0.429)。我们发现,桶柄损伤的失败次数有增加的趋势(p = 0.08),当使用 4 根缝线时,失败次数也有显著增加(p = 0.041)。结论:在该系列研究中,半月板修复术的临床成功率为 85.9%。盘状半月板、桶柄损伤和需要缝合次数较多的患者失败风险较高。对于大多数儿童和青少年的半月板损伤,修复应被视为首选手术治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Clinical results and complications of meniscal repair in children and adolescents].

Introduction: there is scarce information on meniscal repair in the paediatric population in terms of outcomes of this technique. The aim of this study was to evaluate the clinical outcomes and complications of meniscal repair in paediatric population with isolated lesions, associated with ACL rupture and discoid meniscus with unstable lesions.

Material and methods: data from 78 patients 18 years of age, with arthroscopic diagnosis of isolated meniscal lesion, associated with ACL tear or discoid meniscus, in whom arthroscopic repair was performed, were retrospectively analyzed for demographic characteristics, surgical technique, and perioperative complications. Functional results were assessed with the Lysholm and Pedi-IKDC scales. Time to repair failure was defined as the interval between meniscal repair and revision (re-repair or subtotal meniscectomy).

Results: mean age was 14 years (SD 3.1, range 3-19). The patients in group C were significantly younger (15.4 years in group A vs 14.9 in group B vs 12.1 in group C, p = 0.001). The average follow-up was 33.8 months. The mean Lysholm score and Pedi-IKDC were 96.1 points (range, 76-100) and 93.8 points (range, 59.8-100), respectively. The overall failure rate was 14.1% (11/78). There were 4 (13%) failures in group A, 3 failures (12%) in group B, and 5 failures (17%) in group C (p = 0.429). We found a tendency towards a greater number of failures in bucket handle injuries (p = 0.08) and a significant association when 4 sutures were used (p = 0.041).

Conclusion: in this series, meniscal repair demonstrated a clinical success rate of 85.9%. Patients with discoid meniscus, bucket handle injuries, and those who required a greater number of sutures had a higher risk of failure. Repair should be considered the first surgical treatment option for most meniscal injuries in children and adolescents.

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