膝关节疾患的关节镜诊断和微创治疗

目的探讨关节镜下检查和微创治疗各种膝关节疾患，分析132例膝关节疾患的诊断和治疗。方法应用关节镜进行膝关节镜检和根据镜检情况作相应治疗。关节镜技术可以正确评估半月板损伤的部位、类型和范围，合理选择损伤半月板缝合、部分切除等术式，最大限度保留半月板。采用刨削清理增生肥厚的炎性滑膜组织，修平退变剥脱的软骨创面，游离体摘除，去除不稳定骨赘，半月板修整或成型，软骨下钻孔等方法治疗骨关节炎。应用半腱肌腱、股薄肌腱和微型钢板重建前交叉韧带等。结果随访6月～5年，平均（20±2）个月，按lysholm膝关节功能评分标准进行评定〉90分。结论关节镜手术是一种安全实用的诊断和治疗方法。关节镜对膝关节内疾患的诊断直观、明确，镜视下手术创伤小、并发症少、疗效好。

Diagnosis and Treatment of Knee Joint Diseases with Arthroscopy

Objective To explore the diagnosis and treatment of 132 cases of knee joint disease with discover and the minimally invasive treated under arthroscopy. Methods 132 cases were used with arthroscopy on knee joint examination and made corresponding treatment according to the result of arthroscopy. Since the arthroscopic technique can correctly detect the location, type and scope of the meniscus injury, surgeons can be reasonably decided whether the injured meniscus should be sutured or partially resected so as to maintain as most part of meniscus as possible. The procedures included synovectomy, raw surface of degenerated cartilage,loose bodies removing, meniscus figurating, subchondral bone drilling. Anterior cruciate ligament ruptures were reconstructed arthroscopically with semitendionosus and gracilia tendons by endobutton. Results 132 cases were followed up from 6 months to 5 years with an average of （20 ± 2 ） months. According to the standard of knee joint function grade point of lysholm, the patient＇ s knee joint function was assessed 〉 90 mint. Conclusion Arthroscopy was a safe and practical method on diagnosis and treatment. Arthroscopy was a good device to make visual, accurate diagnosis with less injury, fewer complications and better curative effects.