全膝关节置换治疗色素沉着绒毛结节性滑膜炎  

Total knee arthroplasty in the treatment of pigmented villonodular synovitis

作　　者：许福生[1] 祁伟[1] 李桓毅[1] 柯荣军[1] 顾永福[1] 刘方刚[1] 

机构地区：[1]解放军第359医院骨科,江苏212000

出　　处：《中国骨与关节杂志》2015年第4期276-279,共4页Chinese Journal of Bone and Joint

摘　　要：目的：回顾性研究全膝关节置换（ total knee arthroplasty，TKA ）治疗晚期色素沉着绒毛结节性滑膜炎（ pigmented villonod-ularsynovitis，PVNS ）的临床疗效。方法对2000年1月至2011年12月，行 TKA 治疗8例晚期 PVNS 的患者进行回顾性研究，弥漫型6例，局限型2例，年龄34～80岁，平均54.3岁。术中彻底切除滑膜后再行 TKA。术后随访分析复发、松动、感染，比较术前、术后 KSS （ keen society score ）评分。结果随访1.5～12.5年，平均9.2年，KSS 平均评分：临床评分由术前的39.8（25～45）分提高至82.3（70～90）分，功能评分由术前的35（15～55）分提高至73.8（60～90）分。5例膝关节假体固定良好、功能满意，3例弥漫型、2例局限型。3例失败的病例均为弥漫型，1例发生感染，2例复发，其中1例因无菌性松动翻修时诊断。结论 TKA 治疗晚期 PVNS，局限型可获得满意的临床效果，弥漫型可能与假体松动、感染等并发症有关。Objective To retrospective analyze the efifcacy of total knee arthroplasty （ TKA ） in patients with late-stage pigmented villonodular synovitis （ PVNS ） of the knee.Methods From January 2000 to December 2011, 8 patients of late-stage PVNS were retrospectively reviewed. Six patients were of diffuse type, and 2 of focal type. The mean age was 54.3 years （ range： 34-80 years ）. All patients were managed with a complete synovectomy and total knee arthroplasty. Preoperative and postoperative Keen Society Score （ KSS ）, prosthetic loosening, infection and recurrence were analyzed.Results All patients were available for an average duration of follow-up 9.2 years （ range： 1.5- 12.5 years ）. The average KSS improved from preoperative 39.8 （ range： 25-45 points ） to postoperative 82.3 （ range： 70-90 points ）. Average functional score improved from preoperative 35 （ range： 15-55 points ） to postoperative 73.8 （ range： 60-90 points ）. Five of the 8 total knee prostheses were well ifxed and functioning satisfactorily. Three patients were of diffuse type and 2 of focal type. Three failures were in patients of diffuse type. One of the failures was due to infection, and 2 were due to the recurrence of the disease. In one of these patients, the recurrence was diagnosed at the time of the revision arthroplasty performed because of aseptic loosening.Conclusions Total knee arthroplasty can achieve well effects in the treatment of late-stage and focal type PVNS. The diffuse type may be related to the prosthetic loosening and infection after the TKA.

关 键 词：滑膜炎 色素绒毛结节性 关节成形术 置换 膝 膝关节 关节疾病 

分 类 号：R687.4[医药卫生—骨科学]