关节镜下治疗髋关节滑膜软骨瘤的临床疗效

目的总结关节镜下治疗髋关节滑膜软骨瘤的方法及临床疗效。方法 2009年7月-2011年6月,对15例髋关节滑膜软骨瘤于关节镜下行滑膜清理和游离体摘除术。男11例,女4例;年龄21～45岁,平均33.1岁。左髋6例,右髋9例。病程12～43个月,平均23个月。主要临床症状为患侧髋关节活动受限、胀痛。疼痛视觉模拟评分(VAS)为(5.8±1.1)分,髋关节活动度为(149.8±27.5)°,Harris评分为(54.5±13.3)分。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间6个月～2年,平均17.4个月。末次随访时VAS评分为(2.0±1.2)分,髋关节活动度为(258.3±35.4)°,Harris评分为(93.0±18.7)分,以上指标均较术前显著改善,差异有统计学意义(P<0.05)。随访期间MRI检查示均无复发。结论关节镜下治疗髋关节滑膜软骨瘤创伤小,术后恢复快,可最大程度恢复髋关节功能和活动度。

EFFECTIVENESS OF ARTHROSCOPIC TREATMENT FOR SYNOVIAL CHONDROMATOSIS

Objective To explore the technique of arthroscopic treatment of synovial chondromatosis of the hip and to evaluate its effectiveness. Methods Between July 2009 and June 2011, 15 patients with synovial chondromatosis of the hip underwent arthroscopic synovectomy and removal of loose bodier. Of 15 patients, 11 were male and 4 were female, aged from 21 to 45 years with an average of 33.1 years. The location was the left side in 6 cases and the right side in 9 cases. The disease duration was 12-43 months (mean, 23 months) Pain and functional motion limitation were the main clinical symptoms. The visual analogue scale (VAS) score was 5.8 ± 1.1; the range of motion (ROM) of the hip was (149.8 ± 27.5)°; the Harris hip score was 54.5 ± 13.3. Results All incisions healed by first intention. All the patients were followed up 6 months to 2 years (mean, 17.4 months). At last follow-up, the VAS score was 2.0 ± 1.2; the ROM of the hip was (258.3 ± 35.4)°; the Harris hip score was 93.0 ± 18.7; and the above indexes were significantly improved when compared with preoperative values (P < 0.05). No recurrence was found on postoperative MRI. Conclusion Arthroscopic treatment of synovial chondromatosis of the hip has the advantages of minimal invasion, quick recovery, and best recovery of hip function and ROM.