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关节镜前后路联合手术囊外切除腘窝囊肿
Hits: 2134   Download times: 361   Received:December 03, 2013    
作者Author单位UnitE-Mail
王亮 WANG Liang 浙江中医药大学, 浙江 杭州 310053 Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China  
夏炳江 XIA Bing-jiang 浙江中医药大学, 浙江 杭州 310053 Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China  
阮威明 RUAN Wei-ming 浙江中医药大学附属第一医院, 浙江 杭州 310006  
童培建 TONG Pei-jian 浙江中医药大学, 浙江 杭州 310053
浙江中医药大学附属第一医院, 浙江 杭州 310006
Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China tongpeijian@163.com 
肖鲁伟 XIAO Lu-wei 浙江中医药大学, 浙江 杭州 310053
浙江中医药大学附属第一医院, 浙江 杭州 310006
Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China  
金红婷 JIN Hong-ting 浙江中医药大学附属第一医院, 浙江 杭州 310006  
期刊信息:《中国骨伤》2014年27卷,第8期,第635-637页
DOI:10.3969/j.issn.1003-0034.2014.08.004
基金项目:国家自然科学基金资助项目(编号:81202710);浙江省自然科学基金资助项目(编号:Y2111184);浙江省十二五重大专项基金(编号:2012c13017-2)


目的:探讨应用关节镜技术前后路联合手术囊外切除腘窝囊肿的方法及临床疗效。

方法:自2010年1月至2012年12月收治腘窝囊肿20例,其中男14例,女6例;年龄45~65岁,平均49.5岁;左膝12例,右膝8例。发 现腘窝肿块4~18个月,平均12个月,囊肿大小体表纵径3~7 cm,平均4.5 cm.主要临床表现为腘窝部肿块,膝关节肿痛,并伴有不同程度的功能障碍。由MRI确诊为腘窝囊肿,并均与关节腔相通。先后路行关节镜下囊肿囊壁剥 除术,后前路关节镜下处理关节内疾患。术前Rauschning和Lindgren腘窝囊肿分级:Ⅰ级2例,Ⅱ级6例,Ⅲ级12例。通过比较手术前后Rauschning和Lindgren腘窝囊肿分级情况对术后临床疗效进行评定。

结果:20例术后均未 出现并发症,切口均Ⅰ期愈合。所有患者获随访,时间8~24个月,平均16个月,膝关节疼痛症状明显好转,囊肿无复发。术后8个月按Rauschning和Lindgren腘窝囊肿分级法分级:0级14例,Ⅰ级6例,术后腘窝囊肿分级情况 明显改善。

结论:应用关节镜技术前后路联合手术治疗腘窝囊肿临床疗效满意,囊肿囊壁剥除,同时处理关节腔内疾患,可降低囊肿的复发率。
[关键词]:囊肿  关节镜  膝关节
 
Extracapsular arthroscopic excision of popliteal cysts through anterior combined with posterior approach
Abstract:

Objective: To study the clinical effect of arthroscopic excision of popliteal cysts through a combined anterior and posterior approach.

Methods: From January 2010 to December 2012,20 patients with popliteal cysts were treated with arthroscopic excision. There were 14 males and 6 females,with an average age of 49.5 years old,ranging from 45 to 65 years old. The lump has been found for 4 to 18 months,with a mean time of 12 months. Their mean sagittal diameter was 4.5 cm(ranged from 3 to 7 cm). There were 12 popliteal cysts in the left and 8 popliteal cysts in the right. The main clinical manifestation included lump at popliteal fossa,swelling and pain at knee joint and some extent of dysfunction. All diagnoses were determined according to MRI,which clearly showed the communication of cyst and articular cavity. The cyst was removed under arthroscopy,through the posterior approach and then the intra-articular lesion was treated via the anterior approach. According to Rauschning and Lindgren classification,2 patients were gradeⅠ,6 patients were gradeⅡ,and 12 patients were grade Ⅲ. The guidelines of Rauschning and Lindgren were used to evaluate the clinical effects.

Results: No complications such as the injury of blood vessel and nerve,or incision infection occurred in all patients. All the patients were followed up,and the duration ranged from 8 to 24 months,with a mean time of 16 months. According to the criteria of Rauschning and Lindgren,there were 14 cases of grade 0,and 6 cases of gradeⅠafter operation,which was improved obviously compared with that pre-operation. No cyst reoccurred and the knee joint pain was relieved.

Conclusion: Treatment of popliteal cysts with arthroscopic excision through a combined anterior and posterior approach is effective to remove the cyst sac and treat intra-articular diseases simultaneously,resulting in the decrease recurrence rate of cyst.
KEYWORDS:Cyst  Arthroscopes  Knee joint
 
引用本文,请按以下格式著录参考文献:
中文格式:王亮,夏炳江,阮威明,童培建,肖鲁伟,金红婷.关节镜前后路联合手术囊外切除腘窝囊肿[J].中国骨伤,2014,27(8):635~637
英文格式:WANG Liang,XIA Bing-jiang,RUAN Wei-ming,TONG Pei-jian,XIAO Lu-wei,JIN Hong-ting.Extracapsular arthroscopic excision of popliteal cysts through anterior combined with posterior approach[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(8):635~637
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