关节镜下治疗腘窝囊肿的疗效  

The efficacy of arthroscopic treatment for popliteal cyst

作　　者：张江[1] 龚泰芳[1] 卢云[1] 陈文[1] 刘小涛[1] 孙景东[1] 李彬彬[1] 边竟[1] 唐红波[1] 

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)骨关节科,湖北十堰442008

出　　处：《骨科》2017年第4期283-286,共4页ORTHOPAEDICS

基　　金：十堰市科学技术研究与开发项目计划(14Y23)

摘　　要：目的探讨关节镜下切除腘窝囊肿的手术方法与疗效。方法自2013年1月至2014年2月我科采用关节镜下切除25例腘窝囊肿,腘窝囊肿均为单膝,左膝13例、右膝12例。其中,男10例,女15例,年龄为40~65岁。术前常规体检、患膝X线和MRI检查,观察膝关节骨与软组织的病变。膝关节镜手术常规采用前内、前外侧入路,术中常规探查并清理膝关节内病变。评价病人并发症、疼痛、复发情况,采用Lysholm膝关节评分、美国膝关节协会评分(knee society score,KSS)、美国特种外科医院(Hospital for Special Surgery,HSS)评分比较病人术前术后的情况。结果 25例病人均获得随访,随访时间为6~12个月,平均为(9.0±1.9)个月。复查MRI发现1例类风湿性膝关节炎病人腘窝囊肿复发,但无明显临床症状。术前Lysholm膝关节评分为(48.76±12.07)分,术后术后末次随访为(81.72±7.57)分;术前KSS为(52.32±11.16)分,术后末次随访为(85.84±6.85)分;术前HSS评分为(55.62±10.76)分,术后末次随访为(88.64±6.24)分。3个指标术后与术前比较,差异均有统计学意义(均P<0.05)。结论关节镜下打开内侧关节囊与腘窝囊肿之间的"阀门"并切除囊壁,可以达到治疗腘窝囊肿的目的。本研究手术方法简单有效、安全性高,并可同时处理腘窝囊肿的诱发因素,有效地降低囊肿的复发率。Objective To explore the efficacy of arthroscopic surgery treatment for popliteal cyst.Methods From January 2013 to February 2014, 25 patients with popliteal cyst were treated by arthroscopy.There were 10 males and 15 females with age from 40 to 65 years old. The popliteal cysts were unilateral,including 13 cases on the left side and 12 cases on the right side. Preoperative examinations of routine physicalexaminations, X-ray and MRI on the affected knees were performed. Lesions of bones and soft tissues wereobserved. Anterior and anterolateral approaches were used routinely for the knee arthroscopy. Complications,recurrence, Lysholm score of the knee joint, the knee society score(KSS) and the Hospital for Special Surgery(HSS) were recorded. Results All the 25 patients were followed up for 6-12 months. There was 1 case ofrheumatoid arthritis recurred with knee popliteal cyst through MRI, but the patient showed no obvious clinicalsymptoms. Lysholm knee score before the operation was 48.76±12.07 and that at the final follow-up was 81.72±7.57. KSS before the operation was 52.32 ± 11.16 and that was 85.84 ± 6.85 at the final follow-up after theoperation. HSS before the operation was 55.62±10.76 and that at the final postoperative follow-up was(88.64±6.24). There were statistically significant differences(all P<0.05). Conclusion The results show that thearthroscopic surgery treatment for popliteal cyst is simple, effective and safe. And it is convenient to treatpredisposing factors and effectively lower the relapse rate of cyst.

关 键 词：腘窝囊肿 关节镜 滑膜囊肿 单向阀门 

分 类 号：R687.4[医药卫生—骨科学]