| 关节镜下半膜肌腓肠肌囊通道扩大内引流囊壁剥除术治疗腘窝囊肿 |
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Received:October 18, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 吴李闯 |
WU Li-chuang |
温州医科大学附属第一医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China |
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| 周海波 |
ZHOU Hai-bo |
温州医科大学附属第一医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China |
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| 张超 |
ZHANG Chao |
温州医科大学附属第一医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China |
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| 陈雷 |
CHEN Lei |
温州医科大学附属第一医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China |
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| 刘彩龙 |
LIU Cai-long |
温州医科大学附属第一医院骨科, 浙江 温州 325000 |
Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China |
wulichuang2012@163.com |
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| 期刊信息：《中国骨伤》2017年30卷，第4期，第304-308页 |
| DOI：10.3969/j.issn.1003-0034.2017.04.004 |
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目的：探讨关节镜下半膜肌与腓肠肌内侧头滑液囊（gastrocnemius-semimembranosus bursa，GSB）通道扩大内引流囊壁剥除术治疗腘窝囊肿的临床疗效。
方法：回顾性分析2011年5月至2015年12月关节镜下治疗41例腘窝囊肿患者的临床资料，男18例，女23例；年龄34~67岁，平均42.6岁，术前均通过MRI明确囊肿与关节相通，均存在GSB。腘窝囊肿均为单侧，右膝26例，左膝15例。其中5例为复发病例，初次手术术式均采用开放囊肿切除术，初次手术至再次复发时间为6~17个月，平均11个月。均采用关节镜下GSB通道扩大内引流加囊壁剥除术，术前Rauschning和Lindgren分级：Ⅰ级5例，Ⅱ级30例，Ⅲ级6例。术前Lysholm评分83.19±6.12（73~95分）。
结果：41例腘窝囊肿患者在术中均发现存在GSB结构，其中软骨退变损伤33例、内侧半月板损伤27例、外侧半月板损伤7例、游离体8例、色素绒毛结节性滑膜炎2例、滑膜软骨瘤病3例，术后未出现血管、神经或手术切口并发症。41例均获得随访，时间8~27个月，平均18个月，未出现囊肿复发病例。术后Rauschning和Lindgren分级：0级9例，Ⅰ级27例，Ⅱ级4例，Ⅲ级1例。术后Lysholm评分91.32±4.26（82~98分）。
结论：关节镜下GSB通道扩大内引流囊壁剥除术治腘窝囊肿具有创伤小、恢复快、复发率低的优点，近期疗效良好。 |
| [关键词]:腘囊肿 关节镜 膝关节 外科手术 |
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| Therapeutic effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa and cyst wall resection for the treatment of 41 patients with popliteal cysts |
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Abstract:
Objective: To investigate the clinical curative effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa(GSB) and cyst wall resection for the treatment of popliteal cysts.
Methods: A retrospective analysis of patients from May 2011 to December 2015. Arthroscopic treatment for 41 patients with popliteal fossa cysts,18 males and 23 females,aged from 34 to 67 years old,averaged 42.6 years old. All the patients had preoperative magnetic resonance imagings to confirm the diagnosis and identify the valvular opening(Gastrocnemius-Semimembranosus bursa,GSB),as well as the associated intra-articular pathology. All the popliteal cysts were unilateral,including 26 cases of right knees and 15 cases of left knees. Five patients had recurrent popliteal cysts,and all of them underwent initial open Surgery. The duration from initial surgery to the recurrence ranged from 6 to 17 months(averaged,11 months). All the patients had underwent arthroscopic treatment of internal drainage by expanding GSB and cyst wall resection. According to the Rauschning and Lindgren classification,5 cases were gradeⅠ,30 cases were gradeⅡand 6 cases were grade Ⅲ. Preoperative Lysholm score,83.19±6.12 (ranged form 73 to 95).
Results: The GSB structure was found in all patients with popliteal cysts during operation,including cartilage degeneration in 33 cases,medial meniscus injury in 27 cases,lateral meniscus injury in 7 cases,free body in 8 cases,pigmented villonodular synovitis in 2 cases,and synovial chondromatosis in 3 cases. There were no complications related to vascular,nerve or surgical incision. All the patients were followed up,and the duration ranged from 8 to 27 months,with an average of 18 months. No recurrence of cysts was found. According to the Rauschning and Lindgren classification,there were 9 cases of grade 0,27 cases of gradeⅠ,4 cases of gradeⅡ,1 case of grade Ⅲ. Postoperative Lysholm score:91.32±4.26(ranged from 82 to 98).
Conclusion: Arthroscopic internal drainage by expanding GSB and cyst wall resection surgery in the treatment of popliteal cysts has the advantages of less trauma,faster recovery and low relapse rate,which has a good short-term effect. |
| KEYWORDS:Popliteal cyst Arthroscopes Knee joint Surgical procedures, operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 吴李闯,周海波,张超,陈雷,刘彩龙.关节镜下半膜肌腓肠肌囊通道扩大内引流囊壁剥除术治疗腘窝囊肿[J].中国骨伤,2017,30(4):304~308 |
| 英文格式: | WU Li-chuang,ZHOU Hai-bo,ZHANG Chao,CHEN Lei,LIU Cai-long.Therapeutic effects of internal drainage by expanding arthroscopic gastrocnemius-semimembranosus bursa and cyst wall resection for the treatment of 41 patients with popliteal cysts[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(4):304~308 |
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