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膝关节弥漫性色素沉着绒毛结节性滑膜炎常规切开与关节镜滑膜全切比较的临床对照试验
Hits: 2293   Download times: 1431   Received:February 28, 2007    
作者Author单位UnitE-Mail
高文香 GAO Wen-xiang 洛阳正骨医院河南省正河南洛阳471002 Department of Orthopaedics,Luoyang Hospital of Traditional Chinese Orthopedics and Traumotology,Luoyang 471002,Henan,China LXF3552@shou. Com 
郝军 HAO Jun 洛阳正骨医院河南省正河南洛阳471002 Department of Orthopaedics,Luoyang Hospital of Traditional Chinese Orthopedics and Traumotology,Luoyang 471002,Henan,China  
靳国强 JIN Guo-qiang 洛阳正骨医院河南省正河南洛阳471002 Department of Orthopaedics,Luoyang Hospital of Traditional Chinese Orthopedics and Traumotology,Luoyang 471002,Henan,China  
王志伟 WANG Zhi-wei 洛阳正骨医院河南省正河南洛阳471002 Department of Orthopaedics,Luoyang Hospital of Traditional Chinese Orthopedics and Traumotology,Luoyang 471002,Henan,China  
期刊信息:《中国骨伤》2007年20卷,第12期,第815-817页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:比较膝关节弥漫性色素沉着绒毛结节性滑膜炎常规切开滑膜切除与关节镜手术滑膜全切的术后效果,介绍关节镜下滑膜全切方法。

方法:19例患者分2组治疗,常规切开组10例,年龄26~66岁,平均42岁;病程12~30个月,平均18个月;采用常规膝前入路,视野内滑膜全切。关节镜组9例,年龄15~58岁,平均39岁;病程15~36个月,平均21个月;采用常规前内上、前外上、前内下、前外下入路,再作后内、后外辅助入路及跨后纵隔入路。必要时辅助关节外小切口,将滑膜全切。

结果:两组术后均经6~36个月随访,了解患膝活动度及功能情况。最后随访两组膝关节活动度均超过120°,切开组平均132.7°±3.1,°IKDC关节功能主观评分(80.8±4.9)分,Lysholm膝关节功能评分(81.0±4.4)分。关节镜组膝关节活动度平均136.0°±3.5,°IKDC膝关节功能主观评分(82.9±5.0)分,Lysholm膝关节功能评分(81.4±3.6)分。

结论:关节镜组具有比常规切开组更多的优势,术后可早期锻炼,无切口裂开、不愈合等危险,切口感染、关节僵直等风险明显低。因此,关节镜治疗膝关节弥漫性色素沉着绒毛结节性滑膜炎应为首选方法。
[关键词]:膝关节  弥漫性色素沉着绒毛结节性滑膜炎  关节镜  外科手术  临床对照试验  
 
A controlled clinical trial on operation and arthroscopic treatment of diffused pigmented villonodular synovitis of the knee
Abstract:

Objective:To compare the clinical results of operation and arthroscopic treatment of diffused pigmented villonodular synovitis and introduce the technique of arthroscopic treatment.

Methods:Nineteen cases of diffused pigmented villonodular synovitis were treated by operation and arthroscopic treatment.Ten patients were treated by operative synovectomy,average age was 42 years(ranging 26 to 66),with duration of average 18 months(ranging 12 to 30),using nomal routine anterior approach.Nine patients were treated by arthroscopy,average age was 39 years(ranging 15 to 58),with duration of average 21 months(ranging 15 to 36),using routine anterior approach combined with posteromadial,posterolateral and trans-posterior-septal approach.

Results: The patients were followed up for 6 to 36 months,and were evaluated for range of motion and function of the whole leg.At the last followed-up,the range of motion of operative cases reached 132.7°±3.1° on average.According the International Knee Documentation Committee(IKDC) criteria,subjective knee score was 80.8±4.9,the Lysholm score was 81.0±4.4.Arthroscopic cases was 136.0°±3.5° on average,IKDC subjective knee score was 82.9±5.0,the Lysholm score was 81.4±3.6.There was no statistical difference.

Conclusion:In cases of diffused pigmented villonodular synovitis of the knee joint,operation and arthroscopic treatment have a similar clinical results.But the arthroscopic total synovectomy is minimally invasive,and have less complication.It is appropriated for diffused pigmented villonodular synovitis.
KEYWORDS:Knee joint  Diffused pigmented villonodular synovitis  Arthroscopes  Surgical procedures,operative  Controlled clinical trial  
 
引用本文,请按以下格式著录参考文献:
中文格式:高文香,郝军,靳国强,王志伟.膝关节弥漫性色素沉着绒毛结节性滑膜炎常规切开与关节镜滑膜全切比较的临床对照试验[J].中国骨伤,2007,20(12):815~817
英文格式:GAO Wen-xiang,HAO Jun,JIN Guo-qiang,WANG Zhi-wei.A controlled clinical trial on operation and arthroscopic treatment of diffused pigmented villonodular synovitis of the knee[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(12):815~817
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