退行性膝关节髁间撞击征的分型与治疗

目的:探讨退行性膝关节髁间撞击征的概念及分型和各型的关节镜治疗原则和方法。方法:对30例退行性膝关节髁间撞击征病人症状、体征、放射检查及关节镜下表现及治疗方法进行总结分析。结果30例全部随访,时间平均1年,伸膝受限改善率平均80％。撞击感消失,疼痛明显减轻,优:10例,良:14例,可:4例,差:2例。结论:退行性膝关节髁间撞击征是由于股骨髁间窝继发性狭窄和(或)胫骨髁间嵴增生增高和(或)前交叉韧带胫骨起点前缘骨赘增生,造成膝关节伸直位时撞击而出现的相应临床表现。分为3型:A型:股骨髁间窝型,即股骨髁间窝骨赘增生。B型:胫骨髁间嵴型;B1型:胫骨髁间嵴增生增高型;B2:前交叉韧带胫骨起点前缘骨赘增生型;C型:混合型。关节镜下股骨髁间窝扩大成形术和(或)胫骨髁间嵴部分切除术,和(或)前交叉韧带胫骨起点前缘骨赘切除术,是治疗退行性膝关节髁间撞击征的有效微创方法。

Classification and Therapy of Degenerative Intercondylar Impingement Syndrome of Knee Joint

Objective:To discuss the conception and classification of degenerative intercondylar impingement disease of knee joint, the principles and methods to treat different types of the disease via arthroscope. Method:To sum up and analyze the symp-torruthe body characteristic, the X - ray and arthroscope examine result and the arthroscope treatment of 30 cases of degenerative intercondylar impingement disease of knee joint. Results: All the 30 cases were followed up for an average of 1 year, the extension of knee joint was improved 80% in average. Impingement disappeared and pain abated, excellent 10 cases, good 14 cases, common 4 cases,poor:2 cases. Conclusion:Degenerative intercondylar impingement disease of knee joint is the clinic phenomena of impingement in knee joint when stand up caused by secondary stenosis of femoral intercondylar fossa and(or)hyperplasia of tibial intercondylar eminence and (or) bone spur hyperplasia of anterior cruciate ligament on the front edge of the start of shankbone. There are 3 types:type A:of femoral intercondylar fossa,bone spur formed in femoral intercondylar fossa;type B:of tibial intercondylar eminence; type B1:of hyperplasia of tibial intercondylar eminence; type B2:of bone spur of anterior cruciate ligament of the front edge of the start of shankbone; type C: mixed. It is resultful micro-trauma tic method to treat degenerative intercondylar impingement disease to enlarge and form femoral intercondylar fossa, partly resect tibial intercondylar eminence and resect bone spur of anterior cruciate ligament on the front edge of the start of shank bone via arthroscope.