关节镜下后内侧双入路囊壁切除联合内引流治疗腘窝囊肿的临床疗效  

Arthroscopic Cystectomy Combined with Cyst Drainage for Popliteal Cysts through the Double Posteromedial Portal:Short Term Clinical Results

作　　者：李强[1] 韩琼 吴茂厚 张楠心[1] LI Qiang;HAN Qiong;WU Maohou;ZHANG Nanxin(Department of Orthopedic,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Rehabilitation,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院骨科,福州350005 [2]福建医科大学附属第一医院康复科,福州3500051

出　　处：《福建医科大学学报》2020年第3期161-165,共5页Journal of Fujian Medical University

基　　金：福建省自然科学基金面上项目(2017J01283);福建省财政厅专项基金(2018B009);福建省建设高水平医院专项基金(闽财指【2018】376号)。

摘　　要：目的探讨全关节镜下应用后内侧双入路技术行囊壁切除联合囊肿内引流治疗成人腘窝囊肿的短期临床疗效。方法采用全关节镜下后内侧双入路技术治疗成人腘窝囊肿20例。术中扩大囊肿-关节腔交通口进行内引流,同时应用后内侧双切口技术切除囊壁,处理关节腔内病变。术后根据手术前后Rauschning和Lindgren腘窝囊肿分级法及磁共振结果评定临床手术效果。结果随访时间(9.13±2.45)月(6~20月),20例均未出现囊肿复发。Rauschning和Lindgren腘窝囊肿分级法:术前1级5例(25%),2级12例(60%),3级3例(15%);术后随访时提高到0级16例(80%),1级3例(5%),2级1例(15%)(P<0.05)。术后核磁共振复查囊肿消失16例(80%),减小4例(20%);囊肿最长径从术前4.7 cm(4~9 cm)降低到术后0.9 cm(0~2.6 cm)(P<0.05),结果满意。结论全关节镜下后内侧双入路技术行囊壁切除联合囊肿内引流治疗成人腘窝囊肿疗效显著,具有创伤小、恢复快、复发率低等优点。Objective To evaluate the short-term clinical results of arthroscopic treatment of adult popliteal cysts by cyst drainage and cystectomy through the double posteromedial portal.Methods 20 patients with popliteal cysts were treated by arthroscopic method,during operation,the intra-articular disorders were treated and the connecting hole between cyst and knee joint cavity were enlarged,and the cyst was completely resected through the double posteromedial portal.The functional outcome was evaluated by use of the Rauschning and Lindgren knee score.All patients were evaluated by MRI,which documented the popliteal cyst and associated intra-articular lesions preoperatively and at follow-up.Result All patients were followed up for(9.13±2.45)months(6~20 months).According to the guidelines of Rauschning and Lindgren,there were 5 cases of gradeⅠ,12 cases of gradeⅡand 3 cases of gradeⅢbefore surgery.After surgery,there were 16 cases of grade 0,3 cases of grade I(P<0.001).The follow-up MRI study showed that the cyst had disappeared in 16 knees(80%)and had reduced in size in 4 knees(20%)in the 20 patients.The mean cyst size was reduced significantly from 4.7 cm to 0.9 cm(P<0.001).Conclusion The described arthroscopic technique with cystectomy and cyst drainage through the double posteromedial portal is effective for treating popliteal cysts with the advantages of mini-invasive,with quick-recovery,low complication,and low recurrence rate.

关 键 词：关节镜 膝关节 腘窝囊肿 后内侧双入路技术 

分 类 号：R684.3[医药卫生—骨科学]