膝关节镜下膝后侧腔室联合手术入路的探讨  

Combined entrances for the arthroscopic surgery of posterior compartment of the knee joint

作　　者：刘杰 王克力[2] 葛许峰[2] 潘刚[2] 

机构地区：[1]上海长航医院骨关节外科,上海崂山东路523号200122 [2]南通瑞慈医院,江苏226010

出　　处：《中国矫形外科杂志》2007年第2期101-103,I0003,共4页Orthopedic Journal of China

摘　　要：[目的]探讨在关节镜下膝关节后侧腔室联合手术入路的重要性和可操作性。[方法]经过前内侧、前外侧和股骨髁切迹以及后内侧、后外侧和后纵隔内切口联合入路分别入镜、入器械,进行膝关节后侧腔室的探查和手术操作。[结果]216例(239膝)应用联合入路探查和治疗,其中5例膝因关节僵硬操作失败;175例膝用于治疗后侧腔室疾病,膝关节后侧腔室手术视野显著改善,探查和手术操作完善,均达到手术目的。1例膝内侧隐神经不全损伤,没有腘后神经、腓总神经、腘后血管、交叉韧带等重要组织损伤。[结论]膝关节后侧腔室病变较多,是检查和治疗的重要部位,并非“技术盲区”。这种联合手术入路,手术风险低,具备可操作性,可以提高手术效率和质量,可作为膝关节镜下常规手术入路。[ Objective ] To study the feasibility and significance of a safe arthroscopic entrance technique to posterior compartment of the knee joint. [ Method] Exploratory surgery of posterior compartment of 239 knee joints was performed by arthroscope or its working instruments through the combined entrances of anteromedial, anterolateral, intercondylar notch, posteromedial, posterolateral and transseptal. Their results were evaluated. [ Result] With this technique, complete arthroscopic visualization of the posterior compartment of knee joint and arthroscopic procedures for this compartment could be easily performed in 216 cases （239 knees） , except 5 cases with arthro - stiffness. There occurred 1 case of saphenous nerve injury but no complications such as injuries of popliteal neurovascular structures. [ Conclusion ] Combined entrances of posterior compartment of knee joint is a satisfactory approach for arthroscopic surgery of posterior compartment of knee joint and can give a high efficiency and quality of arthroscopic surgery for posterior compartment of knee joint.

关 键 词：膝关节 膝后侧腔室 切口联合入路 关节镜 

分 类 号：R687.3[医药卫生—骨科学]