关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿  

Arthroscopic cyst removal and wire-guided suture for the treatment of lateral meniscal cyst of knee joint

作　　者：代朋乙 谭红略 袁彦浩 李小永 DAI Peng-yi;TAN Hong-lue;YUAN Yan-hao;LI Xiao-yong(Department of Knee Inury,Luoyang Orthopaedic Hospital of Henan Province,Luoyang 471002,He nan,China)

机构地区：[1]洛阳正骨医院河南省骨科医院膝部损伤科,河南洛阳471002

出　　处：《中国骨伤》2018年第10期944-948,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿的临床疗效。方法:2014年7月至2017年12月,采用关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿33例,其中男13例,女20例,年龄20～55 (36.23±2.30)岁;病程3～14 (4.60±0.83)个月;术前MRI检查均诊断明确。关节镜下按囊肿具体部位分前角14例,体部18例,后角1例。所有囊肿为单发,其中3例为多房。术前及术后6个月采用Lysholm膝关节功能评分、GLASOW评分进行临床疗效。结果:术后33例均获得随访,时间6～24 (7.5±1.2)个月。患者术前症状消失或明显减轻,切口均甲级愈合,无伤口感染、神经血管损伤等并发症。MRI示半月板撕裂部及囊肿缺损区已愈合,囊肿无复发。伤口愈合时间8～12(9.6±1.6)周,恢复日常生活及运动。术后6个月Lysholm评分(91.32±3.36)分,与术前(61.12±4.35)分比较差异有统计学意义(t=46.11,P<0.01)。根据GLASOW评分,优31例,良2例。结论:采用关节镜下清除并钢丝引导缝合治疗膝关节外侧半月板囊肿,最大程度地保留了半月板,并同时行半月板损伤修复,术后膝关节功能恢复好,值得临床推广应用。Objective：To explore clinical effect of arthroscopic cyst removal and wire guided suture for the treatment of lateral meniscal cyst of knee joint. Methods：From July 2014 to December 2017,33 patients with lateral meniscal cyst of knee joint were treated by arthroscopic cysts removal and wire guided suture,including 13 males and 20 females,aged from 20 to 55 years old with an average age of（36.23 ±2.30） years old,the courses of disease ranged from 3 to 14 months with an average of（4.60 ±0.83） months;Preoperative MRI examination was clear diagnosed. There were 14 cysts on anterior horn,18 cysts on meniscal body and 1 cyst on posterior horn;all cysts were solitary,and 3 of them were multilocular. Lysholm score and GLASOW score of knee joint function and clinical efficacy were observed before and after operation at 6 months. Results：All patients were followed up form 6 to 24 months with an average of（7.5±1.2） months. Preoperative symptoms disappeared or significantly alleviated,and all incisions were healed by intention without complication and neurovascular injury. MRI showed meniscal tear areas and cystic defective areas healed,cyst was not recurrenced,healing time ranged form 8 to 12 weeks with an average of（9.6±1.6） weeks,and patients recovered their daily life and exercise. There was significant difference in Lysholm score before operation（61.12±4.35） and after operation at 6 momths（91.32±3.36）（t=46.11,P〈0.01）;according to GLASOW assessment,31 patients with excellent recovery,and 2 good. Conclusion：Arthroscopic cyst removal and wire-guided suture for the treatment of lateral meniscal cyst of knee joint could reserve meniscus,repair injury of meniscus,recover knee joint function after operation,and is worth popularizing.

关 键 词：半月板 囊肿 膝关节 关节镜 

分 类 号：R687.4[医药卫生—骨科学]