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[目的]探讨关节镜治疗髋关节滑膜软骨瘤病的方法和疗效,初步提出髋关节滑膜软骨瘤病的镜下分型。[方法]自2001年3月～2008年5月本院收治髋关节滑膜软骨瘤病患者21例,其中男15例,女6例;手术时年龄17～49岁,平均32.4岁;左侧9例,右侧12例。采用关节镜技术取出游离体并行滑膜切除术。病变位于外周间室者术中放松牵引进行手术,对于髋臼窝病变,需要借助弧形刨削刀和可折弯射频。[结果]所有患者术后症状缓解,MRI显示关节积液减少或消失,随访时间11个月～8年,平均45个月,Harris评分由术前的56.2分增加至随访时92分,疗效优良率85.7%。随访期内未见复发。[结论]髋关节镜治疗原发性髋关节滑膜软骨瘤创伤小、术后功能恢复快、效果满意。髋关节滑膜软骨瘤病的镜下分型可以指导手术操作并避免遗漏病变。
[Objective] To explore the method and efficacy of arthroscopic treatment of hip synovial chondromatosis and initially put forward the microscopic classification of hip synovial chondromatosis. [Methods] From March 2001 to May 2008, 21 cases of hip synovial chondromatosis were treated in our hospital, including 15 males and 6 females. The age ranged from 17 to 49 years with an average of 32.4 years 9 cases, right in 12 cases. Arthroscopic technique was used to remove the free synovectomy. Lesions located in the peripheral compartment surgery to relax traction surgery, acetabular fossa lesions, the need for arc shavers and bendable radiofrequency. [Results] The symptoms of all patients were relieved. The MRI showed that the joint effusion decreased or disappeared. The follow-up time ranged from 11 months to 8 years (mean 45 months). The Harris score increased from 56.2 points preoperatively to 92 points at follow-up. Rate of 85.7%. No recurrence during the follow-up period. [Conclusion] Hip arthroscopy treatment of primary hip synovial chondroma small trauma, postoperative recovery quickly, with satisfactory results. Microscopic classification of hip synovial chondromatosis can guide surgical procedures and avoid missing lesions.