摘要
目的：比较膝关节弥漫性色素沉着绒毛结节性滑膜炎常规切开滑膜切除与关节镜手术滑膜全切的术后效果,介绍关节镜下滑膜全切方法。方法：19例患者分2组治疗,常规切开组10例,年龄26~66岁,平均42岁;病程12~30个月,平均18个月;采用常规膝前入路,视野内滑膜全切。关节镜组9例,年龄15~58岁,平均39岁;病程15~36个月,平均21个月;采用常规前内上、前外上、前内下、前外下入路,再作后内、后外辅助入路及跨后纵隔入路。必要时辅助关节外小切口,将滑膜全切。结果：两组术后均经6~36个月随访,了解患膝活动度及功能情况。最后随访两组膝关节活动度均超过120°,切开组平均132.7°±3.1,°IKDC关节功能主观评分（80.8±4.9）分,Lysholm膝关节功能评分（81.0±4.4）分。关节镜组膝关节活动度平均136.0°±3.5,°IKDC膝关节功能主观评分（82.9±5.0）分,Lysholm膝关节功能评分（81.4±3.6）分。结论：关节镜组具有比常规切开组更多的优势,术后可早期锻炼,无切口裂开、不愈合等危险,切口感染、关节僵直等风险明显低。因此,关节镜治疗膝关节弥漫性色素沉着绒毛结节性滑膜炎应为首选方法。
Objective：To compare the clinical results of operation and arthroscopic treatment of diffused pigmented villonodular synovitis and introduce the technique of arthroscopic treatment.Methods：Nineteen cases of diffused pigmented villonodular synovitis were treated by operation and arthroscopic treatment.Ten patients were treated by operative synovectomy,average age was 42 years（ranging 26 to 66）,with duration of average 18 months（ranging 12 to 30）,using nomal routine anterior approach.Nine patients were treated by arthroscopy,average age was 39 years（ranging 15 to 58）,with duration of average 21 months（ranging 15 to 36）,using routine anterior approach combined with posteromadial,posterolateral and trans-posterior-septal approach.Results： The patients were followed up for 6 to 36 months,and were evaluated for range of motion and function of the whole leg.At the last followed-up,the range of motion of operative cases reached 132.7°±3.1° on average.According the International Knee Documentation Committee（IKDC） criteria,subjective knee score was 80.8±4.9,the Lysholm score was 81.0±4.4.Arthroscopic cases was 136.0°±3.5° on average,IKDC subjective knee score was 82.9±5.0,the Lysholm score was 81.4±3.6.There was no statistical difference.Conclusion：In cases of diffused pigmented villonodular synovitis of the knee joint,operation and arthroscopic treatment have a similar clinical results.But the arthroscopic total synovectomy is minimally invasive,and have less complication.It is appropriated for diffused pigmented villonodular synovitis.
出处
《中国骨伤》
CAS
2007年第12期815-817,共3页
China Journal of Orthopaedics and Traumatology
关键词
膝关节
弥漫性色素沉着绒毛结节性滑膜炎
关节镜
外科手术
临床对照试验
Knee joint
Diffused pigmented villonodular synovitis
Arthroscopes
Surgical procedures,operative
Controlled clinical trial
