关节镜下清理术治疗鹅足滑囊炎  

Arthroscopic debridement for pes anserinus bursitis

作　　者：郭旗[1] 袁鹏[1] 刘宁[1] GUO Qi;YUAN Peng;LIU Ning(Department of Sports Medicine,Zhengzhou Orthopaedics Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院运动医学科河南省关节镜诊疗中心

出　　处：《中国矫形外科杂志》2019年第23期2179-2182,共4页Orthopedic Journal of China

摘　　要：[目的]介绍关节镜下清理术治疗鹅足滑囊炎的手术技术和初步效果。[方法]2015年10月~2018年10月在本科初次接受手术治疗的鹅足滑囊炎患者12例,所有患者均在关节镜下微创清理鹅足滑囊局部囊肿。于胫骨结节下缘水平内侧行小切口,建立人工腔隙,插入关节镜,探查鹅足肌腱及滑囊位置,在关节镜监视下于观察通道上方或内侧制备工作通道。置入刨削刀或剥离器暴露鹅足滑囊。刨削刀打开囊壁,清除胶冻状滑囊液等囊腔内容物,逐步彻底切除囊壁组织,射频处理创面残留组织和出血点。[结果]术后均未出现血管、神经或手术切口并发症,未见复发病例。末次随访时,患者膝关节活动度由术前平均(112.50±11.99)°恢复至(134.42±4.23)°,静息性疼痛NRS评分由术前(5.42±1.24)分降低至术后(1.08±0.79)分,活动性疼痛NRS评分由术前(6.83±1.34)分降低至术后(1.42±1.17)分,Lysholm评分由术前(57.25±8.31)分提高至(85.33±7.11)分,手术前后差异均具有统计学意义(P<0.001)。[结论]关节镜下微创清理术治疗鹅足滑囊炎具有创伤小、关节功能恢复快、囊肿切除彻底、不易复发等优点,患肢功能恢复满意。[Objective]To introduce surgical technique and primary clinical outcomes of arthroscopic debridement for pes anserinus bursitis.[Methods]From October 2015 to October 2018,12 consecutive patients with pes anserinus bursitis were treated with arthroscopic debridement.After a small incision was made medially to tibial tuberosity,a subcutaneous cavity was created by dissection.The arthroscope was inserted to localize the cyst,and a working port was made on proper position medially and superiorly.The bursa was opened with shave to remove the contents in it,and then the cyst wall was completely resected.Finally,the bleeding points were cauterized with a radiofrequency coblation.[Results]No serious complications,such as neurovascular injuries and incision infection occurred.The range of motion of the knees improved from(112.50±11.99)°preoperatively to(134.42±4.23)°at final follow-up(P<0.05),the Lysholm score increased from(57.25±8.31)preoperatively to(85.33±7.11)at final follow-up(P<0.05),whereas the NRS for pain at rest decreased from(5.42±1.24)preoperatively to(1.08±0.79)at final follow-up(P<0.05),and the NRS for pain at activity declined from(6.83±1.34)preoperatively to(1.42±1.17)at final follow-up(P<0.05).[Conclusion]Arthroscopic debridement is an effective and reliable treatment for pes anserinus bursitis with quick recovery of knee function and satisfactory clinical outcomes.

关 键 词：鹅足滑囊炎 膝关节 关节镜 

分 类 号：R686.7[医药卫生—骨科学]