摘要
目的 ：观察关节镜下膝关节交叉韧带囊肿治疗的疗效。方法 ：2008年9月至2014年1月,28例膝关节交叉韧带囊肿的患者在关节镜监视下行清除手术,其中男11例,女17例;平均年龄28.3岁（16-56岁）;右膝20例,左膝8例。术前有明确外伤史8例,慢性损伤史5例,无明显诱因15例。24例术前即诊断为交叉韧带囊肿;2例术前据MRI诊断为半月板损伤,1例术前诊断为交叉韧带损伤,1例术前诊断为髌股关节炎,此4例均在术中发现交叉韧带囊肿,术后均修正诊断。交叉韧带囊肿MRI分型：Ⅰ型14例,Ⅱ型6例,Ⅲ型8例。术后休息至少2周并进行下肢肌肉功能训练,依据关节活动度、Lysholm评分、IKDC 2000主观膝关节评分、GLASGOW评定法以及Mc Murray试验、轴移试验、前抽屉试验对术后临床疗效进行评价。结果：所有患者术后切口Ⅰ期愈合,无相关并发症。术后除3例行前交叉韧带射频皱缩和重建手术,余25例均获随访,时间12~52个月,平均26.7个月。末次随访时患者关节活动度由术前的（116.00±5.70）°提高到末次随访时的（123.84±4.59）°,Lysholm评分由术前的59.80±6.58提高到末次随访时的75.32±6.49;IKDC 2000评分由术前的65.36±6.26提高到末次随访时的81.00±5.76,GLASGOW评定法评定25例中优23例,良2例。结论：关节镜下治疗膝关节交叉韧带囊肿短期随访效果良好,术前要仔细查阅MRI,术中认真观察以免遗漏;对于交叉韧带松弛或撕裂的患者,及时给予皱缩或重建,术后应积极训练以便早日康复。
Objective：To evaluate the early clinical effects of arthroscopic treatment for cruciate ligament cysts of the knee. Methods：From September 2008 to January 2014,23 patients with cruciate cysts were treated with arthroscopic surgery.There were 11 males and 17 females,with an average age of 28.3 years old（ranged,16 to 56 years old）. Twenty patients had injuries on the right knee and 8 patients had injuries on the left knee. Eight patients had a history of injury,5 patients had a history of chronic injury,and the other 15 patients had no obvious reasons for the symptom. Before the operation,24 patients were clearly diagnosed as the cruciate ligament cysts of knee joint,and 4 patients were diagnosed as other problems of the knee,but the diagnosis were corrected after the operation. According to the MRI before the surgery,all the patients could be divided into 3 types：14 were typeⅠ,6 were typeⅡ,8 were typeⅢ. After the operation,the patients were suggested to have a rest for 2 weeks,and take exercises everyday at the same time. The knee range of motion,Lysholm score,International Knee Documentation Committee（IKDC） 2000 subjective score,GLASGOW criteria,and Mc Murray test,pivot shift test,and anterior drawer test were observed to evaluate clinical results. Results：All the incisions healed at the first stage without complications.Twenty five patients were followed up,and the duration ranged from 12 to 52 months,with a mean of 26.7 months. Three patients accepted the reconstruction of ACL or tightened elongated ACL using bipolar radio frequency. The Lysholm score increased from preoperative 59.80 ±6.58 to 75.32 ±6.49 at the latest follow up; IKDC 2000 score increased from preoperative65.36±6.26 to 81.00±5.76 at the latest follow-up. According to GLASGOW criteria,23 patients got an excellent result and 2good. Conclusion：It has a satisfactory curative effect on ACL reconstruction using bipolar radio frequency. It has advantages of firm fixation,simple and secure operation as well as quick postoper
出处
《中国骨伤》
CAS
2016年第3期261-265,共5页
China Journal of Orthopaedics and Traumatology
关键词
膝关节
交叉韧带
囊肿
关节镜
Knee joint
Anterior cruciate ligament
Cysts
Arthroscopes
