Iranian Journal of Orthopaedic Surgery Vol 7, No 1 (Serial No 26), Winter 2009:29-34 اﻳﺮان ﻣﻔﺎﺻﻞ و اﺳﺘﺨﻮان ﺟﺮاﺣﻲ ﻣﺠﻠﻪ دوره ﻫﻔﺘﻢ ﺷﻤﺎره، 1 ) ﻣﺴﻠﺴﻞ ﺷﻤﺎره26 ( ، زﻣﺴﺘﺎن1387 ﺻﻔﺤﻪ، ﻫﺎي34 - 29 ﻛﻮﺗﺎه ﻧﺘﺎﻳﺞ ﭘﺎرﮔﻲ درﻣﺎن ﻣﺪت ﺑﻪ آرﺗﺮوﺳﻜﻮﭘﻲ ﻃﺮﻳﻖ از داﺧﻠﻲ ﻣﻨﻴﺴﻚ ﻫﺎي ﻣﻨﻴﺴﻜﺘﻮ ﺻﻮرت ﻛﺎﻣﻞ ﻧﻴﻤﻪ ﻣﻲ * ا دﻛﺘﺮ اﻧﺼﺎﻓﺪاران ﺣﻤﺪ، ** دﻛﺘﺮ اﻧﺼﺎﻓﺪاران، ﺣﻤﻴﺪرﺿﺎ** اﻧﺼﺎﻓﺪاران ﻣﺤﻤﺪرﺿﺎ دﻛﺘﺮ، *** وﺛﻮﻗﻲ اﻣﻴﺮرﺿﺎ دﻛﺘﺮ ﺧﻼﺻﻪ ﭘﻴﺶ زﻣﻴﻨﻪ: ﻋﻠﺖ از ﻳﻜﻲ درﮔﻴﺮي ﺷﺎﻳﻊ ﻫﺎي زاﻧﻮ، ﻫﺎي ﻣﻨ ﭘﺎرﮔﻲ ﻣﻲ داﺧﻠﻲ ﻴﺴﻚ ﺑﺎﺷﺪ. ﺳﺎل ﺑﺮاي ﺑﻮد، ﻣﻨﻴﺴﻚ ﻛﺎﻣﻞ ﺑﺮداﺷﺘﻦ آن اﻧﺘﺨﺎﺑﻲ درﻣﺎن ﻫﺎ ﻧﺘـﺎﻳﺞ اﻣﺎ دراز و ﻧﺪاﺷﺖ ﺧﻮﺑﻲ ﻣﺪت ﺷﺪه ﻋﻤﻞ زاﻧﻮﻫﺎي ﺑﻴﺸﺘﺮ ﻣﻨﺠﺮ ﺳﺎ ﺑﻪ ﻳ ﻫﻨﮕﺎم زود ﻴﺪﮔﻲ ﻣﻲ ﺷﺪﻧﺪ. اﻣـﺮوزه روش آرﺗﺮوﺳـﻜﻮﭘﻲ ﻧﻴﻤـﻪ ﻛﺎﻣـﻞ دوﺧـﺘﻦ و ﻣﻨﻴـﺴﻜﺘﻮﻣﻲ ﻣﻨﻴﺴﻚ، درﺻﻮرت ا ﻣﻜﺎن آن، اﻧﺠﺎم اﺳﺘﺎﻧﺪارد درﻣﺎن اﺳﺖ ﻣﻨﻴﺴﻚ ﭘﺎرﮔﻲ ﻛﻮﺗﺎه ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﻪ، اﻳﻦ در و ﺷﺪ ﺑﺮرﺳﻲ ﺑﻴﻤﺎران از ﮔﺮوﻫﻲ در روش اﻳﻦ ﻣﺪت. روش و ﻣﻮاد ﻫﺎ: ﺗﻌﺪاد110 درد، ﺗﺎرﻳﺨﭽﻪ ﺑﺎ ﺑﻴﻤﺎر زاﻧﻮ ﻛﺮدن ﺧﺎﻟﻲ و ام ﻛﻪ زاﻧﻮ ﻛﺮدن ﻗﻔﻞ آر آي آ ﻧﺸﺎن را داﺧﻠﻲ ﻣﻨﻴﺴﻚ ﭘﺎرﮔﻲ ﻓﻘﻂ ﻧﻬﺎ ﺑـﻮد، داده ﺑـﺮاي ﻣﻨﻴﺴﻜﺘﻮﻣﻲ ﺟﺮاﺣﻲ ﻋﻤﻞ ﻧﻴﻤﻪ ﻛﺎﻣ ﻞ از اﻧﺘﺨﺎب آرﺗﺮوﺳﻜﻮﭘﻲ ﻃﺮﻳﻖ ﺷﺪﻧﺪ. ﺗﺮﺗﻴﺐ ﺑﻪ و ﻋﻤﻞ از ﻗﺒﻞ6 ، 18 و36 ﻋﻤﻞ از ﺑﻌﺪ ﻣﺎه ﭘﺮﺗﻮﻧﮕﺎري ﻫﺎي دو ﻫﺮ اﻳﺴﺘﺎده ﺷﺪ ﮔﺮﻓﺘﻪ زاﻧﻮ. ﻣﻔﺼﻠﻲ، ﻓﻀﺎي ﻣﻴﺰان ﻣﻜﺎﻧﻴﻜﻲ ﻣﺤﻮر و اﺳﺘﺌﻮ وﺿﻌﻴﺖ درﺟﻪ ﺑﺮاﺳﺎس زاﻧﻮ آرﺗﺮﻳﺖ ﺑﻨﺪي» ﻓﺮﺑﺎﻧﻚ« ارزﻳﺎﺑﻲ ﺷﺪ. ﺑـﻪ زاﻧـﻮ ﻃـﻮر ﻛﺎﻣـﻞ ﻣﻌﺎﻳﻨـﻪ، و ﭼﺎرت ﺳﭙﺲ» ﻟﻲﻠﻢُ ﺷ« ﺗﻮﺳﻂ ﺗﻜﻤﻴﻞ ﺑﻴﻤﺎر ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﻧﻬﺎﻳﺖ در87 ﺑﻴﻤﺎر) 78 و ﻣﺮد9 زن( ﺷﺪﻧﺪ ﭘﻴﮕﻴﺮي. ﺳﻨﻲ ﻣﻴﺎﻧﮕﻴﻦ ﻣﺮدان28 ﺳﺎل) 53 - 18 ﺳﺎل( ﺳﻨﻲ ﻣﻴﺎﻧﮕﻴﻦ و زﻧﺎن37 ﺳـﺎل) 50 - 22 ﺳـﺎل( ﺑﻮد. در ﻣﻨﻴﺴﻚ ﭘﺎرﮔﻲ54 % ﺑﺎﻛﺖ، ﻧﻮع4 / 10 % ﻓﻼپ، ﻧﻮع8 % و رادﻳﺎل ﻧﻮع6 / 27 % ﺑﻮد ﻛﻤﭙﻠﻜﺲ ﻧﻮع. ﻣ ﻴﺎﻧﮕﻴﻦ ﻧﻤﺮه» ﻟﻲﻠﻢُ ﺷ« ﻗ ﻋﻤﻞ از ﺒﻞ4 / 48 ) 55 - 41 ( و، 6 ﻣﺎه،18 و ﻣﺎه36 ﺑﻪ ﺗﺮﺗﻴﺐ ﺑﻪ ﻋﻤﻞ از ﺑﻌﺪ ﻣﺎه87 / 80 ) 85 - 73 ( ، 6 / 90 ) 95 - 78 ( و87 / 90 ) 95 - 68 ( ﻳﺎﻓﺖ ﻓﺰاﻳﺶ) 01 / 0 p< .( ﭘﺲ ﻫﻴﭻ ﭘﻴﮕﻴﺮي ﺳﺎل ﺳﻪ از ﺗﻐﻴ ﻴ زاﻧﻮ، ﻣﺤﻮر در ﺮي اﺳﺘﺌﻮ ﻧﻔﻊ ﺑﻪ آن ﺣﺮﻛﺘﻲ داﻣﻨﻪ و زاﻧﻮ ﻣﻔﺼﻠﻲ ﻓﻀﺎي آر ﻧﺸﺪ ﻣﺸﺎﻫﺪه ﺗﺮﻳﺖ. ﻧﺘﻴﺠﻪ ﮔﻴﺮي: ﻣﻨﻴﺴﻜﺘﻮﻧﻲ ﻧﻴﻤﻪ ﻛﺎﻣﻞ ﭘﺎرﮔﻲ ﺑﺮاي ﻣﻨﺎﺳﺒﻲ درﻣﺎن آرﺗﺮوﺳﻜﻮﭘﻲ ﻃﺮﻳﻖ از ﻛﻢ ﻧﺎﺣﻴﻪ ﻫﺎي ﻣﻲ ﻣﻨﻴﺴﻚ ﺧﻮن ﺑﺎﺷﺪ. واژﻫﺎي ﻛﻠﻴﺪي: زاﻧﻮ، آرﺗﺮوﺳﻜﻮﭘﻲ، ﻣﻨﻴﺴﻚ، ﻣﻨﻴﺴﻜﺘﻮﻣﻲ ﻧﻴﻤﻪ ﻛﺎﻣﻞ ﻣﻘﺎﻟﻪ درﻳﺎﻓﺖ: 4 ؛ ﭼﺎپ از ﻗﺒﻞ ﻣﺎه ﺑﺎزﻧﮕﺮي و اﺻﻼح ﻣﺮاﺣﻞ: 2 ؛ ﺑﺎر ﭘﺬﻳﺮش ﻣﻘﺎﻟﻪ: 15 روز ﭼﺎپ از ﻗﺒﻞ Short Term Results of Arthroscopic Partial Meniscetomised Patients *Ahmad Ensafdaran, **Hamidreza Ensafdaran, **Mohammadreza Ensafdaran, ***Amirreza Vosoughi Abstract Background: Meniscal injury is a major cause of functional impairment of the knee .Total meniscectomy was the treatment of choice for many years, but long-term results were not satisfactory. Nowadays, minimal partial meniscectomy performed arthroscopically, or meniscal repair when practical, have become the standard choice. Methods: One hundred and ten patients with stable knee and history of pain, giving way, and locking, which their MRI showed only medial meniscus tear were selected for partial meniscectomy. Evaluation included a patient radiological evaluation by Fairbanks classification for operated and non-operated knee, physical examination and Lysholm score before and 6, 18, 36 months after operation. Results: Only 87 patients (78 men, 9 women) were available for follow-up. Mean age for men was 27.8 years (18-53 years) and for women 36.9 years (22-50 years). Meniscus tear was bucket handle in 54%, flap in 10.4%, radial in 8%, and complex in 27.6% of cases. Mean Lysholm score was 48.4 (range: 41-55) before operation which increased to 80.87 (range: 73-85), 90.6 (range: 78-95), and 90.87 (range: 68-95) six, eighteen, and thirty six months after operation, respectively (p<0.01). In a three-year follow-up, no change was seen in anatomical axis of the knee, joint space width, and range of motion of the knee. Conclusions: The arthroscopic partial medial meniscectomy leads to excellent subjective and functional outcomes. Keywords: Knee; Partial meniscectomy; Arthroscopy; Meniscus Received: 4 months before printing ; Accepted: 15 days before printing *Orthopaedic surgeon, Department of Orthopaedics, Shiraz University of Medical Science, Shiraz, IRAN ** General Practitionare, Department of Orthopaedics, Shiraz University, Shiraz, IRAN ***Resident of orthopaedic surgery, Department of Orthopaedics, Shiraz University of Medical Science, Shiraz, IRAN Corresponding author: Ahmad Ensafdaran Shahid Chamran Hospital, Orthopaedic unit, Shiraz, Iran E-mail: hensafdaran1@yahoo.com