髋关节滑膜软骨瘤病的关节镜下治疗  

Arthroscopic treatment of synovial chondromatosis of hip joint

作　　者：王志刚[1] 刘玉杰[1] 梁永辉[1] 蔡谞[1] 李众利[1] 魏民[1] 朱娟丽[1] 韦映娟[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《中国矫形外科杂志》2010年第5期359-361,共3页Orthopedic Journal of China

基　　金：国家科技支撑计划课题(编号:2006BAK37B09)

摘　　要：[目的]探讨关节镜治疗髋关节滑膜软骨瘤病的方法和疗效,初步提出髋关节滑膜软骨瘤病的镜下分型。[方法]自2001年3月～2008年5月本院收治髋关节滑膜软骨瘤病患者21例,其中男15例,女6例;手术时年龄17～49岁,平均32.4岁;左侧9例,右侧12例。采用关节镜技术取出游离体并行滑膜切除术。病变位于外周间室者术中放松牵引进行手术,对于髋臼窝病变,需要借助弧形刨削刀和可折弯射频。[结果]所有患者术后症状缓解,MRI显示关节积液减少或消失,随访时间11个月～8年,平均45个月,Harris评分由术前的56.2分增加至随访时92分,疗效优良率85.7%。随访期内未见复发。[结论]髋关节镜治疗原发性髋关节滑膜软骨瘤创伤小、术后功能恢复快、效果满意。髋关节滑膜软骨瘤病的镜下分型可以指导手术操作并避免遗漏病变。[Objective] To evaluate the treatment effect of the synovial chondromatosis of the hip through arthroscopy,and to describe the arthroscopic classification.[Methods]From March 2001 to May 2008,21 patients underwent arthroscopic management for primary synovial chondromatosis of the hip.Of the 21 patients,15 were male and 6 were female,aged from 17 to 49 years.The disease was located on the left side in 9 patients,the right side in 12.Anterior and anteriolateral approaches were selected for synovectomy and removal of free bodies.The peripheral compartment received traction,and curved scraper and Slide Winder Blade（the bending radio frequency）were used to deal with the acetabular fossa.[Results]The range of motion of the hip was improved and the pain was released after operation.MRI showed hydrops articuli was reduced or vanished.Harris hip score for the series of patients improved from 56.2 points preoperatively to 92 points at the mean follow-up of 45 months（11 to 96）.Of the 21 patients,18（85.7%）had excellent or good outcomes.No recurrent case was found.[Conclusion]Hip arthroscopy proved beneficial for patients diagnosed with synovial chondromatosis of the hip.It had the advantages of minimal invasion,quick recover and satisfactory outcomes.Arthroscopic classification may guide the procedure and avoid omision of the free bodies.

关 键 词：软骨瘤病 滑膜 髋关节 游离体 关节镜 

分 类 号：R738.1[医药卫生—肿瘤]