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王予彬,王惠芳,崔 芳,孙文琳,朱文辉,袁 锋,卢亮宇.运动员膝关节半月板损伤微创术后的康复[J].中国康复医学杂志,2008,23(1):8~10
运动员膝关节半月板损伤微创术后的康复    点此下载全文
王予彬  王惠芳  崔 芳  孙文琳  朱文辉  袁 锋  卢亮宇
同济大学附属东方医院运动医学科,上海,200120;同济大学附属东方医院运动医学科,上海,200120
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摘要:
      目的:研究运动员膝关节半月板损伤微创术后康复的特点及其存在问题。方法:本组病例分为A组(运动员组)36例,B组(普通人群组)45例,经临床检查与MRI检查术前诊断为膝关节半月板损伤,并由一位关节镜专科医师用微创外科技术行损伤半月板部分切除术。术后采用康复计划,由一组治疗师实施康复训练。随访时采用临床症状、体征、Lyshlom评分法、膝关节百分法进行评估。结果:A组2例,B组1例剧烈活动后关节疼痛,A组2例分别于术后8个月和16个月损伤膝关节前交叉韧带再手术,其余病例临床症状消失,关节功能正常。Lyshlom评分:A组术前:51.85±18.65,术后93.00±7.00,B组术前:52.38±16.02,术后:92.00±6.00(P<0.01)。膝关节百分法:A组术前:49.56±16.64,术后:92.00±5.00;B组术前:50.43±16.02,术后:94.00±6.00(P<0.01)。两组术前、术后评分相互比较差异无显著性(P>0.05)。结论:采用微创外科技术及其康复计划治疗膝关节半月板损伤,无论是运动员还是非运动员都取得满意的临床效果,但对竞技运动员来讲,存在术后早期康复中过度负荷和训练引起临床症状的倾向,康复中后期的肌力训练和本体感觉训练等显然达不到运动员竞技状态恢复的要求,相关的研究值得康复医学界的重视。
关键词:运动员  膝半月板  损伤  微创治疗  康复
Study on rehabilitation post-mini-invasive surgery of meniscus tear in athletes    Download Fulltext
Dept. of Sports Medicine of Dongfang Hospital, Tongji University, Shanghai, 200120;Dept. of Sports Medicine of Dongfang Hospital, Tongji University, Shanghai, 200120
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Abstract:
      Objective:To study the characteristic and problems existed in rehabilitation after-mini-invasive surgery of meniscus tears in athletes. Method:The patients with meniscus tear were divided into group A (athletes group) 36 and group B( non-athletes group) 45. All patients, which had been diagnosed as meniscus tear through clinical check and MRI, were subjected to arthroscopic partial meniscectomy and the rehabilitation training post-operatively, performed by a arthroscopic surgeon and a team of therapists respectively. The results were evaluated with clinical symptoms and sign, Lyshlom scale, knee functional scale(the percentage method). Result:Our patients were followed up with 18 months averagely(13—60 months). All patients achieved satisfactory clinical results and very good knee function except knee pain after strennous activities in 2 patients in group A and 1 patients in group B. ACL of two patients in group A had been injuried and reconstructed in 8 months and 16 months after the surgery respectively. Lyshlom scale: group A 51.85±18.65 pro-operatively and 93±7 post- operatively (P<0.01); group B 52.38±16.02 pro-operatively and 92±6 post-operatively(P<0.01). Knee functional scale: Group A 49.56±16.64 pro-operavely and 92±5 post- operatively(P<0.01). Group B 50.43±16.02 pro-operatvely and 94±6 post-operatively(P<0.01). There was no statistic significance in both scales between group A and group B both pro-operation and post-operation. Conclusion:The satisfactory results could be achieved through current arthroscopic surgery and rehabilitation program in treatment of meniscus tear both in athletes and non-athletes. But we do have lots problems for athletes to gain competitive ability of sports in the early stage of arthroscopic surgery and rehabilitation training program in treatment of meniscus tear. The further investigation concerned should be focused on reduction of the knee pain in the early stage of rehabilitation training caused by over force bearing, strengthening of muscle function and proprioceptive training in order to improve the competitive status for athletes.
Keywords:athlete  knee  meniscus  tear  arthroscopy  rehabilitation
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