改良镜下技术治疗外侧半月板囊肿  

A modified arthroscopic technique for lateral meniscus cyst

作　　者：孙敏 高志[1] 陈鹏旭 胡勇[1] SUN Min;GAO Zhi;CHEN Peng-xu;HU Yong(Department of Sports Trauma and Knee Surgery,Sichuan Provincial Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院膝关节运动损伤,四川成都610041

出　　处：《中国矫形外科杂志》2022年第10期925-928,共4页Orthopedic Journal of China

摘　　要：[目的]介绍改良镜下技术治疗外侧半月板囊肿的手术技术和初步临床效果。[方法]回顾性分析2017—2018年本科收治的膝关节外侧半月板囊肿共120例患者的临床资料,所有患者均采用改良镜下技术治疗,包括半月板水平撕裂处半月板下表面予以切除,囊液内引流,滑膜囊壁组织彻底切除。采用Lysholm膝关节功能评分、Tegner评分进行临床疗效评估,术后3 d内及末次随访的MRI评估囊肿复发情况。[结果]所有患者均顺利完成手术,无血管、神经损伤等严重并发症。术后无感染、血栓、关节僵硬发生。120例患者均获得随访,平均随访时间(34.03±6.69)个月。末次随访Lysholm评分及Tegner评分较术前显著改善(P<0.05)。影像方面,术后3 d内复查MRI显示115例(95.83%)患者半月板囊肿已完全切除,末次随访时,复查MRI示所有患者均无复发,包括5例患者部分囊肿残留。[结论]改良关节镜技术治疗膝关节外侧半月板囊肿,能最大限度地切除囊肿及囊壁组织,术后膝关节功能恢复好、囊肿复发率低。[Objective] To introduce the surgical technique and preliminary clinical outcomes of a modified arthroscopic technique for lateral meniscus cyst of the knee. [Methods] A retrospective study was conducted on 120 patients who underwent arthroscopic surgery for lateral meniscus cyst from January 2017 to December 2018. All the patients received a modified arthroscopic therapy, involving resection of the lower part of the teared meniscus, drainage of cyst fluid, and complete resection of synovial cyst wall, meniscus repaired if necessary.Lysholm and Tegner scores were used for evaluation of clinical outcomes, while MRI at 3 days after surgery and the latest follow-up was taken to evaluate the resection and recurrence of cysts. [Results] All the 120 patients underwent the arthroscopic procedures smoothly without serious complications, such as injuries to blood vessels and nerves. The Lysholm score [(56.21±7.51) versus(88.82±3.46) ] and Tegner score [(3.74 ±0.64) versus(5.92±0.72) ] significantly improved at the latest follow-up compared with those preoperatively(P<0.05). Radiographically, the MRI 3 days postoperatively showed that cyst had been completely resected in 115 cases(95.8%) except partial remnants in other 5 cases, while the MRI at the latest follow-up revealed that no cyst recurred in all patients including the 5 cases who had cyst existed partially. [Conclusion] This modified arthroscopic technique does maximize resection of cyst and cyst wall tissue, with advantages of good recovery of postoperative knee joint function, and lower postoperative recurrence rate for lateral meniscus cyst of the knee.

关 键 词：外侧半月板撕裂伴囊肿 改良关节镜技术 囊肿切除术 

分 类 号：R687[医药卫生—骨科学]