不同原因所致踝关节软骨损伤的关节镜治疗  

Arthroscopic treatment for cartilage damage of ankle due to different causes

作　　者：宋斌[1] 李卫平[1] 杨睿[1] 张正政[1] 王立晖[1] 

机构地区：[1]中山大学孙逸仙纪念医院运动医学科,广州510120

出　　处：《中国骨科临床与基础研究杂志》2012年第2期97-101,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探讨应用关节镜技术治疗不同原因所致踝关节软骨损伤的临床疗效。方法回顾性分析2008年1月至2010年10月在中山大学孙逸仙纪念医院采用关节镜治疗的39例不同原因所致踝关节软骨损伤患者的临床资料,其中骨折18例、软组织撞击综合征7例、剥脱性骨软骨炎5例、痛风性关节炎5例、色素沉着绒毛结节性滑膜炎4例。采用美国足踝外科协会(AOFAS)踝-后足评分系统评价关节功能,前抽屉应力位X线片评估关节稳定性。结果 37例患者获得随访,随访率为95%;随访时间12～24个月(平均18.5个月)。随访结束时踝-后足评分为(84±4)分,优于术前的(54±6)分,两者比较,差异有统计学意义(t=24.249,P=0.000)。18例骨折患者术前和随访结束时的距骨前移距离分别为(15.2±2.5)mm和(3.5±0.2)mm,两者比较,差异有统计学意义(t=19.792,P=0.000)。1例色素沉着绒毛结节性滑膜炎患者术后6个月复发,再次行关节腔病灶清除术后随访15个月未见复发。结论踝关节镜技术可用于治疗不同原因引起的踝关节软骨损伤,近期疗效满意。Objective To observe the methods and experience of arthroscopic treatment for cartilage damage of ankle caused by different causes. Methods A retrospective study was conducted to include a total of 39 patients who undewent arthroscopic treatment for cartilage damage of ankle due to different causes at Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2008 to October 2010. Among them, there were 18 patients with fracture, 7 with impingement syndrome, 5 with osteochondritis dissecans, 5 with gouty arthritis and 4 with pigmented villonodular sunovitis （PVNS）. Clinical rating systems for the ankle （AOFAS） were used to evaluate the functions of ankle joint, and the anterior drawer stress radiographs were performed to assess the stability of ankle joint. Results Thirty-seven cases were followed up for an average of 18.5 months （12-24 months）. Compared with the preoperative AOFAS score, the postoperative one increased （from 54 ± 6 to 84 ± 4）, the difference was statistical significant （t = 24.249, P = 0.000）. For 18 patients with fracture, compared with the preopernative anterior talar translation, postoperative one decreased from （15.2 ± 2.5） mm to （3.5 ±0.2） mm （t = 19.792, P = 0.000）. One patient with PVNS relapsed six months after operation, and then no recurrence occured during 15 months’ follow-up after the second arthroscopic debridement. Conclusion Ankle arthroscopy techniques can deal with cartilage damage of ankle due to different causes, and show satisfactory short-term results

关 键 词：踝损伤 软骨 关节镜检查 

分 类 号：R687.4[医药卫生—骨科学]