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目的探讨关节镜治疗膝关节滑膜软骨瘤病的疗效。方法 2005年1月—2009年10月,对23例(28膝)滑膜软骨瘤病患者入院行X线片、关节活动度检查、视觉模拟评分以及Lysholm膝关节功能评分。根据镜下所见分为表浅型6例,游离体型17例。结合病理学检查行Milgram分期,Ⅱ期16例,Ⅲ期7例。所有患者均行关节镜下病变滑膜切除及游离体取出治疗。结果所有患者均随访13～57个月,平均(32.3±6.7)个月,术后伤口均甲级愈合。术后(5.05±2.43)d恢复正常生活或工作。症状明显改善21例(91.30%),部分改善2例(8.70%),对疗效满意23例(100%)。膝关节关节活动度由术前的伸膝(14.29±16.34)°以及屈膝(106.07±35.83)°提高到术后的伸膝(1.79±2.79)°及屈膝(132.64±35.64)°,差异具有统计学意义(P<0.05)。负重行走时疼痛视觉模拟评分由术前的(3.81±2.02)分降低到术后的(0.37±0.65)分(P<0.05)。Lysholm评分由术前的(43.20±8.24)分升至术后6个月的(86.72±5.40)分(P<0.05);术后1年复诊并检查膝关节正侧位X线片,均未见滑膜软骨瘤体,所有患者无复发。结论关节镜下游离体取出术联合病变滑膜切除术疗效满意,关节疼痛明显减轻,功能恢复,是一种治疗膝关节滑膜软骨瘤病确切有效的方法。
Objective To investigate the curative effect of arthroscopy on synovial chondromatosis in knee joint. Methods From January 2005 to October 2009, 23 patients (28 knees) with synovial chondromatosis were admitted to the hospital for X-ray examination, motor activity test, visual analogue scale and Lysholm knee functional score. According to the microscope, there are 6 cases of superficial type and 17 cases of free type. Combined with pathological examination line Milgram stage, 16 cases of stage Ⅱ, 7 cases of stage Ⅲ. All patients underwent arthroscopic synovectomy and free removal of the body. Results All the patients were followed up for 13-57 months, with an average of (32.3 ± 6.7) months. The wounds were healed by grade A after operation. Postoperative (5.05 ± 2.43) d to return to normal life or work. Symptoms were significantly improved in 21 cases (91.30%), partial improvement in 2 cases (8.70%), and satisfactory results in 23 cases (100%). The knee joint activity ranged from preoperative knee extension (14.29 ± 16.34) ° and knee flexion (106.07 ± 35.83 °) to postoperative knee extension (1.79 ± 2.79) ° and flexion knee (132.64 ± 35.64) °, with statistical difference Significance (P <0.05). The pain visual analog scale decreased from 3.81 ± 2.02 to 0.37 ± 0.65 postoperatively (P <0.05). The Lysholm score rose from (43.20 ± 8.24) points to (86.72 ± 5.40) points at 6 months after surgery (P <0.05). One year after operation, the positive lateral radiographs of knee joint See synovial chondroma, all patients without recurrence. Conclusions Arthroscopic removal combined with synovial resection of the lesion is effective, joint pain is significantly reduced, and functional recovery is an effective and effective method for the treatment of synovial chondromatosis in the knee.