RÉSUMÉ
Objective?To explore the effect of meniscus partial excision under arthroscopy for meniscus injury of knee joint, and compare it with meniscus plasty and conservative treatment.?Methods?The clinical data of 95 patients with meniscus injury of knee joint from September 2012 to September 2015 were analyzed retrospectively. According to the treatment plan, the patients were divided into partial meniscectomy group (37 cases), meniscus angioplasty group (30 cases) and conservative treatment group (28 cases). After 6 months of treatment, the clinical curative effect was evaluated. After 6 months and 2 years of treatment, L-ROM was used to measure the range of motion, and the visual analogue scale (VAS) was used to evaluate the pain degree. The knee function score (Lysholm) was issued to evaluate knee function. The incidence rates of long-term complications in the three groups were recorded.?Results?The total response rate in partial meniscectomy group (97.30%) and meniscus angioplasty group (86.68%) were higher than conservative treatment group (53.57%) (P < 0.05). There was no significant difference between partial meniscectomy group and meniscus angioplasty group (P > 0.05);After 6 months and 2 years of treatment, the knee range of motion and Lysholm scores of the three groups were significantly higher than those before treatment while VAS scores were significantly lower (P < 0.05). However, there were no significant differences between partial meniscectomy group and meniscus angioplasty group (P > 0.05) but there was significant difference, compared with conservative treatment group (P < 0.05). Lysholm scores of partial meniscectomy group were significantly higher than meniscus angioplasty group and conservative treatment group (P < 0.05), and there was significant difference between meniscus angioplasty group and conservative treatment group (P < 0.05).?Conclusion?The effect of arthroscopic surgery in the treatment of meniscus injury of knee joint is accurate. Arthroscopic partial meniscectomy has more advantages in improving the knee function.
RÉSUMÉ
Objective To investigate the efficacy and safety of intravenous tranexamic acid(TXA)admin-istration combined with intra-articular"cocktail"+TXA infusion in primary total knee arthroplasty(TKA). Meth-ods 90 patients were randomly divided to experimental group A,control group B and control group C,30 cases in each group.There was no significant difference(P>0.05) in the preoperative general informations,such as age, sex,body mass index,hemoglobin,hematocrit,D-dimer,preoperative KSS score,knee activity ROM,VAS scores,operation time,time of using tourniquet. All the patients were intravenously injected with TXA 1g before using the tourniquet. After suturing the capsule,for the group A,100 ml of TXA and cocktail mixture(TXA 1g, ropivacaine 40 mg,epinephrine 0.1 mg,methylprednisolone 40 mg) were perfused into the articular cavity through the drainage which then be clamped.By the same ways,group B patients infused with tranexamic acid solution 100 mL(TXA 1g),group C patients infused with saline 100 mL.The total blood loss volume,drainage volume,intraop-erative blood loss,hidden blood loss,the change of hemoglobin and hematocrit in postoperative 3 days,blood trans-fusion,adverse reactions,the VAS scores at 6,12,24,72 h in the postoporative quiescent condition and the VAS scores at 12,24,72 h in the postoporative activity condition were measured and compared.Results The volume of total blood loss,hidden blood loss,drainage,were(685.7 ± 120.6)mL、(259.9 ± 162.0)mL、(151.5 ± 48.9)mL in group A,the decrease of hemoglobin and hematocrit at postoperative 3 d were(18.6 ± 3.2)g/L、(3.1 ± 1.3)% in group A,there was statistically significant(P<0.05) comparing with the control groups.The VAS scores of experi-mental group in the resting and the active state were lower than that in control groups(P < 0.05). Conclusion The application of intravenous tranexamic acid administration combined with intra-articular"cocktail"+TXA infu-sion can reduce the volume of postoperative total blood loss,drainage and hidden blood loss.Simultaneously,it can significantly alleviate the early postoperative pain,which is conducive to early rapid recovery,while not increasing the risk of thrombosis,and no adverse reactions.