The Clinical Outcomes Of Arthroscopic Debridement For Meniscus Injuries And Percutaneous Decompression For Bone Marrow Edema Syndrome

Background:Bone marrow edema(BME)syndrome is a kind of special but under-diagnosed pain symptoms which occurs in lower extremity.The etiology and pathogenesis is still controversial,and it lacks of a gold standard of treatment.Because of its reversibility,duration of conservative treatment to a certain extent can relieve pain,improve functions,reversed course,however it have a long treatment period and the effect of some cases is not satisfaction.Meniscus injury combined knee bone marrow edema occurs in older patients,often to the medial meniscus injury with tibial platform or within the femoral condyle edema,mechanism is unknown,may be related to mechanical stress after meniscus injury resulted from BME.This study aims to investigate the effect of Arthroscopic debridement for meniscus injuries and treatment of percutaneous decompression for knee bone marrow edema syndrome.Methods:22 cases of meniscus injury combined knee bone marrow edema were chosen,who come from the fourth affiliated hospital of Nanchang university in January 2009-January 2014.They underwent arthroscopic meniscal repair and percutaneous core decompression therapy which were done by the same doctor.All patients followed up to 24 months.Comparing preoperative with postoperative on visual analogue scale(VAS),Lysholm score,magnetic resonance imaging(MRI)performance and patient satisfaction,respectively.Results:The outcome of follow-up on postoperative 1,3,6,12,24 months: Compared to preoperative,the mean value of VAS was significantly lower than before,and had statistically significant differences.Only six patients feel pain and interfere with sleep and tolerable,which influenced appetite and sleep on postoperative one month.The VAS score after postoperative three months are less than six points.Few patients feel pain and interfere with sleep,but tolerable.The effect is best on six months to one year postoperative,the VAS score increases slightly after two years postoperative;however.The mean value of Lysholm was significantly improved than before,and had statistically significant differences.20 cases of patients have serious obstacle of knee joint on preoperative.Knee joint function is obviously improved on postoperative.The improvement is best on six months to one year postoperative.The Lysholm score slightly reduced after two years postoperative.Six months postoperatively,the signs of bone marrow edema on MRI disappear completely,the original area had no obvious pain,the signs of bone marrow edema on MRI are consistent with the results of clinical.At the last time of follow-up,eighteen patients were satisfied with the surgical effect.Patient satisfaction was 82%.Conclusions:Arthroscopic debridement for meniscus injuries and treatment of knee bone marrow edema syndrome by percutaneous decompression can effectively relieve the symptoms of meniscus injuries accompanied by knee bone marrow edema syndrome.And it can be used as an effective clinical treatment of meniscus injury combined with knee bone marrow edema syndrome.