膝关节镜下膝后侧腔室联合手术入路的探讨

目的]探讨在关节镜下膝关节后侧腔室联合手术入路的重要性和可操作性。方法]经过前内侧、前外侧和股骨髁切迹以及后内侧、后外侧和后纵隔内切口联合入路分别入镜、入器械，进行膝关节后侧腔室的探查和手术操作。结果]216例（239膝）应用联合入路探查和治疗，其中5例膝因关节僵硬操作失败；175例膝用于治疗后侧腔室疾病，膝关节后侧腔室手术视野显著改善，探查和手术操作完善，均达到手术目的。1例膝内侧隐神经不全损伤，没有腘后神经、腓总神经、腘后血管、交叉韧带等重要组织损伤。结论]膝关节后侧腔室病变较多，是检查和治疗的重要部位，并非“技术盲区”。这种联合手术入路，手术风险低，具备可操作性，可以提高手术效率和质量，可作为膝关节镜下常规手术入路。

Combined entrances for the arthroscopic surgery of posterior compartment of the knee joint

Objective]To study the feasibility and significance of a safe arthroscopic entrance technique to posterior compartment of the knee joint.Method]Exploratory surgery of posterior compartment of 239 knee joints was performed by arthroscope or its working instruments through the combined entrances of anteromedial,anterolateral,intercondylar notch,posteromedial,posterolateral and trans-septal.Their results were evaluated.Result]With this technique,complete arthroscopic visualization of the posterior compartment of knee joint and arthroscopic procedures for this compartment could be easily performed in 216 cases(239 knees),except 5 cases with arthro-stiffness.There occurred 1 case of saphenous nerve injury but no complications such as injuries of popliteal neurovascular structures.Conclusion]Combined entrances of posterior compartment of knee joint is a satisfactory approach for arthroscopic surgery of posterior compartment of knee joint and can give a high efficiency and quality of arthroscopic surgery for posterior compartment of knee joint.