关节镜诊治色素绒毛结节性滑膜炎的临床探讨

目的:通过关节镜下手术对色素绒毛结节性滑膜炎(PVNS)的诊断、治疗进行探讨。方法:回顾23例病人进行膝关节镜的诊断及滑膜刨削,常规前外上、前内下、前外下三切口进行刨削,经过6月~9年随访(平均52月)。7例患者属局限性(结节性)PVNS,行滑膜部分切除,16例为弥漫性PVNS,行广泛滑膜刨削,均由病理证实为PVNS,5例术后行放疗,其余均未进行放疗。结果:本组病人中局限性病人未发现复发,弥漫性病人有1例复发,再次手术后治愈,本组病人无感染、僵直和神经血管损伤。结论:关节镜下手术是诊断和治疗PVNS的有效治疗手术,对弥漫性PVNS要进行广泛彻底滑膜刨削。

Clinical Investigation Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Knee

Objective:The purpose of the study is to critically examine the results of arthroscopic synovectomy in the knee affected by pigmented villonodular synovitis(PVNS),to determine the safety and effectiveness of the procedure.Method: The study population consists of 23 patients,with an average follow-up of 52 months(minimum,6;maximum,108) by a retrospective case analysing.All patients underwent knee arthroscopy.The 3 standard portals were used.7 patients were affected by localized PVNS and were subject to patial synovectomy.The remaining 16 patients presented a diffuse form of PVNS and underwent extended arthroscopic synovectomy.The diagnosis was confirmed by synovial biopsy.Result: In the group affected by the localized form of PVNS,the arthroscopic local excision resulted in a complete and persistent regression of the pathology.Among the patients affected by the diffuse form of PVNS,clinical results were better and only 1 patient was recurred.No relevant complications were encountered.In particular,no cases of infection,stiffness,or neurovascular lesions were seen.Conclusion: Arthroscopic synovectomy is an appropriate treatment for knee PVNS.Extended synovectomy must be performed in all cases of diffuse PVNS.