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目的探讨表现巨大游离体及(或)大量游离体的复杂膝关节滑膜软骨瘤病的关节镜治疗。方法 2001年10月至2012年5月我科关节镜诊治21例表现巨大游离体及(或)大量游离体的复杂膝关节滑膜软骨瘤病,临床表现为膝关节肿胀、疼痛,X线平片和CT发现有巨大游离体及(或)大量游离体,关节镜检查及术后病理确诊,并行关节镜下滑膜软骨瘤摘除和病变滑膜切除术。结果表现为巨大游离体的多位于髌上囊,需增加辅助切口取出。表现为大量较小游离体存在于关节腔、少量微小软骨游离体多数局限于滑膜组织内,不需要增加辅助切口。21例患者均经病理检查证实,全部获得随访,平均随访18个月,所有病例术后功能较术前改善,未见复发,但游离体巨大、多发并有软骨明显损害的患者术后仍遗留不同程度的关节疼痛。结论对于表现巨大游离体及/或大量游离体的复杂膝关节滑膜软骨瘤病,关节镜是该病有效诊断及治疗方法。
Objective To investigate the arthroscopic treatment of complex synovial chondromatosis of the knee that manifests a large free body and / or a large number of free bodies. Methods From October 2001 to May 2012, 21 cases of complex synovial chondromatosis of the knee with giant free body and / or large amount of free body were diagnosed and treated by arthroscopy in our department. The clinical manifestations were knee swelling, pain, X-ray A large free body and / or a large number of free bodies were found on the films and CT, and arthroscopy and postoperative pathology were confirmed. Arthroscopically synovial chondroma removal and synovectomy were performed. The results showed a large free and more in the suprapatellar capsule, need to increase the auxiliary incision out. The performance of a large number of smaller free in the joint cavity, a small amount of tiny cartilage free body mostly confined to the synovial tissue, without the need for additional auxiliary incision. Twenty-one patients were confirmed by pathological examination and all were followed up for an average of 18 months. All patients had better postoperative function than that before operation, and no recurrence was found. However, patients with huge free body mass and significant cartilage damage remained after operation Different degrees of joint pain. Conclusions Arthroscopy is an effective diagnostic and treatment modality for the complex synovial chondromatosis of the knee that manifests a large free body and / or a large amount of free body.