외측 원판형 연골판 파열에서 윤곽 성형술과 추가적인 봉합술을 시행한 군에서의 임상적 결과 비교
Comparison of Clinical Results for Repairing Lateral Discoid Meniscus Tear between the Contouring Surgery Group and the Additional Repair Group
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목적: 외측 원판형 연골판 파열에서 윤곽 성형술(contouring surgery)을 시행한 군과 추가로 봉합술을 시행하였던 군의 임상적 결과를 비교하였다. 대상 및 방법: 2003년 9월부터 2007년 2월까지 수술적 치료를 시행한 외측 연골판 파열 환자 92명 중 2년 이상 추시 관찰이 가능했던 58명 60예를 대상으로 하였다. 관절경적 윤곽 성형술을 시행한 32예는 A군, 봉합술을 추가로 시행했던 28예를 B군으로 분류하고 두 군 간의 증상 이환 기간, 파열 양상 및 임상적 결과를 비교하였다. 결과: 가장 많은 파열 양상은 A군에서 종파열과 중심혈 파열이었고, B군은 복잡 파열이었다. 치료 방법에 따른 증상 이환 기간은 A군의 경우 평균 5.6개월(범위: 1∼24), B군은 16.6개월(범위: 1∼84)로 통계적으로 유의한 차이를 보였다(p=0.025). Ikeuchi의 임상적 평가 방법에 따른 결과에서 양호 이상의 결과는 두 군간의 유의한 차이를 보이진 않았으나(p=0.12), 우수 결과는 A군에서 유의하게 많았다(p=0.031). 결론: 외측 원판형 연골판 파열 치료에서 윤곽 성형술 및 봉합술을 실시한 경우 윤곽 성형술을 시행한 군에 비해 증상 이환 기간이 길고, 복잡 파열이 흔히 존재하였으며 우수한 임상적 결과가 적었다.
Abstract
Purpose: We aimed to compare the clinical results of treating lateral discoid meniscus tear between the contouring surgery group and the additional repair group. Materials and Methods: We evaluated 60 cases (58 patients) with lateral discoid meniscus tear and who were arthroscopically treated between September 2003 and February 2007 and we followed them for at least two years. The sixty cases were divided into two groups: thirty-two cases underwent contouring surgery (Group A) and twenty-eight cases underwent contouring surgery and repair (Group B). The duration of symptoms, the tear patterns and clinical results between the two groups were investigated. Results: The most frequent types of tear pattern were longitudinal and central hole tears in group A, while complex tear was most common in group B. The mean duration of the symptoms was 5.6 months (range: 1∼24) in group A and 16.6 months (range: 1∼84) in group B, which was statistically significant (p=0.025). Based on Ikeuchi’s grading, the proportions with good or excellent outcomes were not different between the two groups (p=0.12). However, group A had a larger proportion of excellent outcomes (p=0.031) than group B. Conclusion: The contouring surgery and additional repair group had a significant longer duration of symptoms, a more complex tear pattern and less excellent results than did the contouring group.
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