全关节镜下内引流技术治疗腘窝囊肿

目的:对比全关节镜下内引流技术与关节镜联合后方小切口技术治疗腘窝囊肿的临床疗效。方法:2015年1月至2017年1月收治腘窝囊肿患者60例,男29例,女31例,年龄30～65(47.8±2.5)岁,病程(8.5±4.2)个月。其中30例接受全关节镜下内引流技术治疗(全关节镜组),30例接受关节镜联合后方小切口技术治疗(关节镜联合小切口组)。对两组手术时间、术中出血量、切口长度、术后Rauschning和Lindgren分级0级恢复率及膝关节Lysholm评分进行对比。结果:全关节镜组29例和关节镜联合小切口组28例获得随访,时间8～20(12.8±2.1)个月。手术时间:全关节镜组(45.32±5.71) min,关节镜联合小切口组(44.56±3.85) min;术后Rauschning和Lindgren分级0级恢复:全关节镜组23例,关节镜联合小切口组22例;术后膝关节Lysholm评分:全关节镜组84.5±11.2,关节镜联合小切口组83.2±12.7;两组比较差异均无统计学意义(P0.05)。术中出血量:全关节镜组(5.32±1.25) ml,关节镜联合小切口组(20.75±8.18) ml;切口长度:全关节镜组(1.51±0.34) cm,关节镜联合小切口组(7.34±0.75) cm;两组比较差异有统计学意义(P0.05)。两组末次随访均行膝关节MRI检查,无囊肿复发病例。结论:全关节镜下内引流技术与关节镜联合后方小切口技术治疗合并关节内病变腘窝囊肿的临床疗效相当,但创伤更小,术后恢复更快。

Total arthroscopic internal drainage technique for the treatment of popliteal cyst

Objective:To compare the clinical effects of total arthroscopic internal drainage and arthroscopic combined with posterior small incision in the treatment of popliteal cyst.Methods:From January 2015 to January 2017,60 patients with popliteal cyst were treated,including 29 males and 31 females,aged 30 to 65(47.8±2.5) years old,with a course of disease (8.5±4.2) months. Among them,30 cases received total arthroscopic internal drainage for popliteal fossa cyst(total arthroscopic group),30 cases received arthroscopic combined with posterior small incision for popliteal fossa cyst(arthroscopic combined with small incision group). The operation time,intraoperative bleeding volume,incision length,Rauschning and Lindgren grade 0 recovery rate and Lysholm score were compared between the two groups.Results:Twenty-nine patients in total arthroscopy group were followed up,and 28 patients in arthroscopy combined with small incision group were followed up for 8 to 20(12.8±2.1) months. Operation time:total arthroscopic group(45.32±5.71) min,arthroscopic combined small incision group (44.56±3.85) min;Rauschning and Lindgren grade 0 recovery:23 cases in total arthroscopic group,22 cases in arthroscopic combined small incision group;postoperative Lysholm score:total arthroscopic group 84.5±11.2,arthroscopic combined small incision group 83.2±12.7;there was no significant difference between the two groups(P>0.05). Intraoperative bleeding volume:total arthroscopic group(5.32±1.25) ml,arthroscopic combined small incision group(20.75±8.18) ml;incision length:total arthroscopic group (1.51±0.34) cm,arthroscopic combined small incision group (7.34±0.75) cm;the difference between the two groups was significant(P<0.05). At the last follow-up,the knee joint was examined by magnetic resonance imaging,and no recurrence of cyst was found.Conclusion:Total arthroscopic internal drainage and arthroscopic combined with posterior small incision technique for popliteal fossa cyst with intra-articular lesions have the same clinical effect,but less trauma and faster recovery.