膝关节滑膜软骨瘤病28例诊治体会

目的:探讨膝关节镜下膝关节滑膜软骨瘤病的诊断和治疗效果。方法:自1995年3月至2011年7月治疗滑膜软骨瘤病患者28例,其中男18例,女10例;年龄25～81岁,平均55.2岁;病程0.5～15年,平均5.6年。症状主要为膝关节疼痛、肿胀和功能受限。分别采用膝关节开放手术(17例)和膝关节镜手术(10例)进行治疗。观察其临床症状、影像学、病理表现及关节镜下的治疗效果。采用膝关节Lysholm评分对治疗前后的疗效进行评价。结果:27例获随访(1例失访),时间6～24个月。开放手术患者膝关节Lysholm评分由术前的(41.89±6.81)分增加到术后的(67.73±7.62)分;关节镜组患者膝关节Lysholm评分由术前的(40.78±7.54)分增加到术后的(77.46±8.43)分。结论:关节镜手术无切口裂开、不愈合等危险,术后可以早期功能锻炼,是诊断和治疗膝关节滑膜软骨瘤病的良好方法。

Diagnosis realization of knee joint synovial chondromatosis:clinical data of 28 cases

Objective:To investigate diagnosis and therapeutic effects of knee joint synovial chondromatosis with arthroscopic. Methods:From March 1995 to July 2011,28 patients with knee joint synovial chondromatosis were treated. Among them,18 males and 10 females ranging age from 25 to 81 (mean 55.2) years,the course of disease ranged from 0.5 to 15 (mean 5.6) years. Clinical manifestation mainly included pain,swell and functional limitation of knee joint. Knee open surgery (17 cases) and laparoscopic surgery(10 cases) were respectively used. Clinical symptom,image data,pathological manifestation and effects under arthroscopy were observed,Lysholm scoring was used to evaluate effects. Results:All patients were followed up except one lost,the duration ranging from 6 to 24 months. Lysholm score in knee open surgery was increased from(41.89±6.81) preoperatively to(67.73±7.62) postoperatively;while in laparoscopic surgery it was increased from (40.78±7.54) preoperatively to (77.46±8.43) postoperatively. Conclusion:Arthroscopic surgery,which has no risk of rupture of incision,nonunion,earlier to exercise,is a good method to diagnosis and treat knee joint synovial chondromatosis.