髋关节滑膜软骨瘤病的诊断与治疗

[目的]探讨髋关节滑膜软骨瘤病的早期诊断与手术疗效。[方法]5例髋关节原发性滑膜软骨瘤病患者,左侧3例,右侧2例。采用髋关节Smith-Petersen切口十字形切开关节囊进入关节腔切除增生肥厚滑膜、清除游离体。[结果]随访6～48个月,平均28个月,全部治愈。[结论]该病早期诊断困难,临床、放射学及病理检查相结合是确诊关键;采用髋关节前外侧入路显露术清除游离体、切除病变滑膜,疗效确切。     

髋关节滑膜软骨瘤病的关节镜下治疗

[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。     

Ganz入路埋头螺钉固定股骨头骨折

[目的]介绍Ganz入路埋头螺钉固定股骨头骨折的手术技术和初步临床结果。[方法] 2015年1月—2021年9月,对10例股骨头骨折患者采用Ganz入路埋头螺钉固定治疗。从髂后上棘下约5 cm处经大转子向大腿外侧中线向下做长12～20cm的切口,用摆锯自大转子顶点后上方至股骨外侧肌后缘纵向截骨,使大转子截骨块的厚约1.5 cm。将截下的大转子连同臀中肌、股外侧肌向前方牵开,显露关节囊,沿股骨颈的长轴偏向关节囊外侧“Z”形切开关节囊。屈曲、外旋股骨,将股骨头向前外侧脱位。清理髋关节关节腔内游离骨块及髋臼周围坏死、挫伤严重组织。复位股骨头较大骨块后用克氏针进行临时固定,根据骨块大小采用2～3枚直径2.4～3.5 mm埋头螺钉固定股骨头骨块并将钉尾埋到软骨下。内旋复位股骨头,复位大转子截骨块后以2枚皮质骨螺钉固定。[结果]所有患者均顺利完成手术,手术时间平均（139.5±30.5） min,术中出血量为（310.0±213.2） ml。恢复完全负重活动时间为术后3～6个月。术后6个月髋关节功能（Thompson-Epstein标准）：优5例,良4例,可1例。[结论] Ganz入路埋头螺钉固定...     

关节滑膜软骨瘤病

本文叙述12例滑膜软骨瘤病的病因、病理,临床表现,诊断与鉴别诊断及治疗方法,经随访,疗效满意。滑膜软骨瘤病是一种滑膜疾病,主要表现为关节滑膜化生形成多数软骨小体,偶见于滑囊或腱鞘内,软骨小体不断生长,或脱落入关节腔,逐渐长大,部分发生钙化或骨化,故亦称滑膜骨软骨瘤病。本病应尽早诊断,手术为本病唯一有效的的治疗方法,效果良好,取出游离体及切除病变滑膜,避免了游离体长期存在于关节内引起的继发性病变,给病人造成难以弥补的伤害。     

S-ROM假体全髋关节置换术联合股骨粗隆下截骨治疗Crowe Ⅳ型髋关节发育不良

目的 评估S-ROM假体全髋关节置换术联合股骨粗隆下截骨治疗Crowe Ⅳ型髋关节发育不良的临床疗效.方法 回顾性分析自2010-01-2016-12采用全髋关节置换术治疗的36例Crowe Ⅳ型髋关节发育不良,经后外侧入路或改良Hardinge入路显露髋臼及股骨,于股骨小粗隆上方约1 cm行股骨颈截骨,采用S-ROM...     

肩关节滑膜骨软骨瘤病1例并文献复习

正滑膜骨软骨瘤病是一种良性关节滑膜疾病,病理特征为滑膜下纤维组织增生,关节滑膜内软骨基质钙化或骨化~([1])。该病的病因尚不明确,好发于30~50岁人群,且男女比例为2∶1~([2])。病变部位多累及大关节,膝关节发病率最高,髋关节次之~([3]),肩关节发病较为罕见~([3-6])。目前手术治疗方式主要包括切开或关节镜下游离体摘除、滑膜切除,但术后复发率尚不明确~([5-7])。笔者于2017-05诊治1例肩关节滑膜骨软骨瘤病,对     

髋关节滑膜骨软骨瘤病1例报告

髋关节滑膜骨软骨瘤病１例报告孙启刚谭金月刘光亮谭宝利滑膜骨软骨瘤病是一种少见的关节滑膜疾病，国内文献报告约９０例，大多数发生于膝关节。我科收治１例发病于髋关节的病人，且一次手术取出３２３个游离骨软骨块，尚属少见。患者，男，３８岁，农民。因左髋部间歇性...     

关节镜下肘关节滑膜软骨瘤病的诊断和治疗

目的探讨肘关节滑膜软骨瘤病的临床特点及关节镜术在该病诊断和治疗中的应用价值、操作要点及临床疗效。方法 1997年1月～2007年1月15例肘关节滑膜软骨瘤病患者行关节镜下清理术,术前所有患者均有不同程度的疼痛及活动受限,10例患者有关节绞锁病史。术中采用多入路结合清除关节内游离体及病变滑膜。采用改良HSS肘关节评分作为疗效评定标准。结果 15例患者随访2.5～12年(平均5.6年)。肘关节平均伸屈活动范围从术前的(85.6±11.3)°提高到术后的(121.2±10.1)°。肘关节疼痛、肿胀症状减轻,关节绞锁消失。改良HSS评分由术前的(48.2±13.6)分提高到术后的(79.8±12.5)分。6例患者非常满意,7例满意,2例不满意,满意率为86.7%。结论关节镜下关节清理术治疗肘关节滑膜软骨瘤病可取得良好效果,适当的入路选择、规范的镜下操作和病变滑膜的彻底清除是影响疗效和预防复发的关键。     

髋关节滑膜软骨瘤病一例报告

髋关节滑膜软骨瘤病一例报告管廷进方留辉李兴学陈新良滑膜软骨瘤病是一种少见的关节滑膜疾患。本病发生在髋关节且一次手术取出１５３个游离体更较少见。我院１９９５年７月收治１例。患者男，３８岁，干部。因右髋部间歇性疼痛４年，加重１个月就诊。无外伤史。曾多次在...     

半开放式关节镜下治疗髋关节滑膜软骨瘤病一例报告

半开放式关节镜下治疗髋关节滑膜软骨瘤病一例报告鲁英罗先正滑膜软骨瘤病是一种少见的良性关节病变，关节滑膜增生、化生为软骨结节，后期钙化、骨化，产生关节疼痛、弹响、绞锁，妨碍关节功能。传统治疗为广泛关节切开，摘除游离体，滑膜部分或全部切除。我科近期利用关...     

关节镜下诊断与治疗滑膜软骨瘤病

目的：探讨关节滑膜软骨瘤病在关节镜下的表现、诊断要点、治疗及疗效分析。方法：本组24例,共26个关节,其中膝关节23个,肘关节2个,踝关节1个;男17例,女7例,男女比例2．4：1;年龄18－73岁,平均53岁。均行关节镜检查镜下软骨瘤取出及病变滑膜切除,并描述了该病在关节镜下的表现形式（滑膜表面型;滑膜层包裹型;关节囊纤维层包裹型;游离体型）和处理方法。结果：22例24个关节获得了平均24．5个月随访,未见复发,关节功能均好于术前,效果满意。仅有2例遗漏了2个游离体,无其它并发症。结论：关节镜下游离体摘除和滑膜切除术是治疗滑膜软骨瘤病的良好方法。     

Synovial osteochondromatosis of the hip joint. Etiology, diagnostic investigation and therapy

Synovial osteochondromatosis (Reichel's syndrome) of the hip joint is an unusual entity that is difficult to diagnose in the initial stages. In the beginning the condition is characterized by recurrent pain in the affected joint with negative radiographic and MR findings. The first stage shows only synovial reaction without loose bodies. In the second stage radiography is negative because of cartilaginous bodies, and even in the third stage radiography is negative in one third of cases although osseous bodies are present. After diagnosis surgery is indicated to prevent damage to the joint. We review the etiology, clinical findings and differential diagnosis especially types of secondary synovial chondromatosis and discuss ultrasound, radiologic, MR and scintigraphic features and laboratory findings. We describe the surgical treatment and postoperative treatment of patients with synovial osteochondromatosis with moderate signs of secondary osteoarthritis.     

Synovial chondromatosis in a facet joint of a cervical vertebra

STUDY DESIGN: A case report of a cervical facet joint synovial chondromatosis. OBJECTIVES: To correlate the radiologic and histologic features of vertebral synovial chondromatosis with review of the literature. SUMMARY OF BACKGROUND DATA: Only two previous cases of vertebral facet joint synovial chondromatosis were found in a review of the English language medical literature. METHODS: A 39-year-old woman had severe cervical pain associated with neurologic signs and symptoms in the left upper extremity. Computed tomographic and magnetic resonance imaging studies were performed. RESULTS: Imaging studies showed lytic defects in the laminae of C3 and C4, with intermediate T1 and high T2 signal intensities. The diagnostic impression was that of a lymphangioma or synovial cyst. A laminectomy showed synovial tissue in both the C3-C4 facet joint and the lamina bone. Histologic examination disclosed synovial chondromatosis. CONCLUSIONS: Synovial chondromatosis of the vertebral spine is quite rare, this being only the third reported example. Direct invasion of the cancellous bone, as in this case, also is a very uncommon feature of chondromatosis. It is emphasized that when radiologic studies demonstrate a lesion with cartilaginous characteristics within or juxtaposed to a joint, synovial chondromatosis, despite its rarity, should be included in the differential diagnosis, regardless of the anatomic site.     

Synovial chondromatosis of the elbow in a child

Synovial chondromatosis is cartilaginous metaplasia of mesenchymal remnants of synovial tissue of the joints. Its main characteristic is the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies). It usually presents between the third and fifth decades and is rare in children. It presents as a mono-articular pathology affecting large joints such as the knee, hip, and elbow. The main symptoms are pain, swelling, and limitation of movements in the affected joint. Diagnosis is made by panoramic radiographs, computed tomography scan, and mainly magnetic resonance imaging and on surgery. The authors describe of synovial chondromatosis presenting in the elbow of an 11 year-old girl which is unreported to the best of our knowledge.     

Surgery for synovial chondromatosis. 26 cases followed up for 6 years

Surgery was performed in 31 patients with synovial chondromatosis: 12 had synovectomy and removal of loose bodies, and 16 had removal of loose bodies only. The remaining 3 patients had more radical surgery: 2 had total hip replacement and 1 had resection arthroplasty. Twenty-six patients were reviewed after an average of 6 years and 4 months. Thirteen patients were symptomatic and 11 had residual signs of limited joint motion and localized tenderness. In 1 case of metatarsophalangeal joint involvement, recurrence occurred. Removal of loose bodies only did not differ from synovectomy and removal of loose bodies.     

Surgery for synovial chondromatosis: 26 cases followed up for 6 years

Surgery was performed in 31 patients with synovial chondromatosis: 12 had synovectomy and removal of loose bodies, and 16 had removal of loose bodies only. The remaining 3 patients had more radical surgery: 2 had total hip replacement and 1 had resection arthroplasty. Twenty-six patients were reviewed after an average of 6 years and 4 months. Thirteen patients were symptomatic and 11 had residual signs of limited joint motion and localized tenderness. In 1 case of metatarsophalangeal joint involvement, recurrence occurred. Removal of loose bodies only did not differ from synovectomy and removal of loose bodies.     

Vertebral synovial chondromatosis. Report of two cases and review of the literature

Synovial chondromatosis is an uncommon disorder characterized by the formation of multiple cartilaginous nodules within the synovium, most commonly affecting large joints. Its involvement with the spine is rare; only six cases have been reported. The authors describe two patients with synovial chondromatosis involving the cervical spine. In the first case, synovial chondromatosis arose from the left C1-2 facet joint. This patient underwent a two-stage procedure including a posterior approach for tumor resection and occipitocervical fusion as well as a transmandibular circumglossal approach to the anterior craniocervical junction to complete the tumor removal. Interestingly, on histopathological examination, scattered foci of low-grade chondrosarcoma were intermixed within the synovial chondromatosis. To the authors' knowledge, this is the first report of secondary low-grade chondrosarcoma arising in vertebral synovial chondromatosis. In the second case, synovial chondromatosis involved the left C4-5 facet joint. Tumor resection and cervical fusion were performed via a posterior approach. In this report, the authors describe the clinical presentation, radiographic findings, operative details, histopathological features, and clinicoradiological follow-up data obtained in these two patients and review the literature pertaining to this rare entity.     

Synovial chondromatosis of the ankle joint and elbow in two cases

Two male patients, aged 44 and 88 years, presented with complaints of restricted joint movement, a growing swelling, and pain in the elbow and ankle joints, respectively. Radiographs showed cartilaginous nodules in the affected joints and minimal chondral damage. Magnetic resonance findings were consistent with synovial chondromatosis. Both patients underwent removal of loose bodies by open arthrotomy and partial synovectomy. Histopathologic examination confirmed the diagnosis. No recurrences were detected within a follow-up period of at least a year.     

Synovial chondromatosis of the metacarpophalangeal joint: case report and review of the literature

Intra-articular synovial chondromatosis in the hand is rare but should be considered in the differential diagnosis of a swollen, stiff or painful joint. Other possible diagnoses include osteoarthritis, rheumatoid arthritis, gout, trauma and chronic infection, and unless enchondral ossification of loose bodies is seen the diagnosis of synovial chondromatosis may not be made preoperatively. A 69-year-old man with synovial chondromatosis of the metacarpophalangeal joint is reported. The joint was swollen and tender. He had not sustained trauma and there was no evidence of arthritis, involvement of other joints or infection. Complete synovectomy with removal of all loose bodies was successful and his symptoms resolved. Intra-articular synovial chondromatosis is a benign condition, but spontaneous resolution is the exception and surgical synovectomy remains the most effective treatment.     

关节镜下诊断与治疗膝关节滑膜软骨瘤病

目的 报道膝关节滑膜软骨瘤病１５例,均用关节镜诊断及治疗,所有病例均经病理检查证实。作者对关节镜在术本病诊断中的优点,分型及治疗方法进行探讨,方法 所有１５例病例均为膝关节病变,左膝关节６例,右膝关节７例,双侧膝关节２例。主要临床症状为关节疼痛,交锁及反复肿胀,关节镜术野好,可全面检查关节腔,具有放大作用,可提高本病的诊断率并有助于分型,关节镜下可将本病分为三型,表浅型,深在型和游离体型,治疗采用