关节镜下治疗踝关节色素沉着绒毛结节性滑膜炎疗效分析  

ARTHROSCOPIC TREATMENT OF PIGMENTED VILLONODULAR SYNOVITIS OF ANKLE

作　　者：王飞[1] 李箭[1] 李棋[1] 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国修复重建外科杂志》2014年第7期832-834,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨关节镜下治疗踝关节色素沉着绒毛结节性滑膜炎（pigmented villonodular synovitis,PVNS）的方法和临床疗效。方法 2005年1月-2012年5月,收治12例踝关节PVNS患者。男6例,女6例;年龄20-50岁,平均35.4岁。左踝8例,右踝4例。病程6个月-12年,中位时间3.6年;其中1例为复发。美国矫形足踝协会（AOFAS）踝与后足功能评分为（55.5±7.6）分。根据病变范围及程度分型,4例局限型PVNS行关节镜下滑膜切除术,8例弥漫型PVNS行关节镜辅助下切开手术治疗;术后均联合局部放疗。结果术后切口均Ⅰ期愈合。12例均获随访,随访时间1-6年,平均2.8年。术后12个月时,踝关节无明显肿胀、疼痛,踝关节活动度均正常;踝关节AOFAS评分为（84.3±3.4）分,较术前显著提高（P〈0.05）,与术后3个月评分（82.8±3.8）分比较,差异亦有统计学意义（P〈0.05）。随访期间均未见复发。结论对于踝关节PVNS,根据病变范围及程度,选择关节镜下滑膜切除术或关节镜辅助下切开手术治疗,术后联合局部放疗,具有创伤小、恢复快及并发症少的优点,可取得满意疗效。Objective To investigate the ef ectiveness of arthroscopic treatment of pigmented villonodular synovitis（PVNS） of the ankle. Methods Twelve patients who were initially diagnosed as having PVNS of the ankle were treated between January 2005 and May 2012. There were 6 males and 6 females, aged 20-50 years（mean, 35.4 years）. Disease duration ranged from 6 months to 12 years（median, 3.6 years）. One case of recurrence was included. The preoperative American Orthopaedic Foot and Ankle Society（AOFAS） ankle-hindfoot score was 55.5 ± 7.6. According to degree and range of the PVNS lesions, 4 cases of local PVNS were treated with arthroscopic debridement, and 8 cases of dif use PVNS were treated with arthroscopically assisted arthrotomy; and local radiotherapy was given in all patients after operation. Results Primary healing of incision was obtained in all patients. The mean follow-up time was 2.8 years（range, 1-6 years）. At 12 months after operation, no obvious pain, swelling, and limited range of motion of the ankle were observed. The AOFAS score was increased to 84.3 ± 3.4 at 12 months, and it was signii cantly higher than that at preoperation（P〈0.05） and at 3 months after operation（82.8 ± 3.8）（P〈0.05）. There was no recurrence during follow-up. Conclusion Arthroscopic arthrotomy combined with postoperative radiotherapy are recommended for PVNS of the ankle according to the PVNS lesion degree and range. And arthroscopically assisted surgery has many advantages of less traumas and hemorrhage, fast recovery, and less complications.

关 键 词：关节镜 踝关节 色素沉着绒毛结节性滑膜炎 

分 类 号：R687.4[医药卫生—骨科学]