创伤后膝前滑膜异常增生的临床探讨

目的　研究膝关节外伤后由于滑膜异常增生产生膝前疼痛的诊断和治疗。方法　 34例外伤后病人均膝前疼痛 ,镜下发现髌韧带旁内侧关节间隙滑膜出现炎症或息肉状滑膜增生 ,并给予切除。结果　术后平均随访 1 4个月 (2～ 2 4个月 ) ,Lysholm评分由术前 5 6 7分上升到 96 2分 (t=2 34,P <0 0 5 ) ,疼痛得分改善由 5 4分提高到 2 4 1分 (t=2 37,P <0 0 5 ) ,34例疼痛均消失 ,2 7例 (79% )股骨内髁软骨出现Outerbidge分类的Ⅰ～Ⅱ度的损伤未进行处理 ,9例 (2 6 % )术后出现关节血肿 ,于穿刺加压包扎后治愈。结论　创伤后膝关节由于滑膜病理性增生引起的膝前疼痛 ,经手术切除可取得满意的效果 ,增生的滑膜有时会引起股骨内髁软骨的轻度改变

Clinical Research of Knee Pain Causing By Synovium Hypertrophy

Objective To describe the arthroscopic clinical findings and treatment for pathologic hypertrophy of synovium in conjunction with knee pain.Methods A group of 34 patients,ranging in age from 13 to 64 years(mean 28 years) with pathologic hypertrophic changes of the synovium in the anteromedial joint compartment were studies.Pathologic changes included inflammation and hypertrophic synovium with polyp appearance.All patients with pathologic synovium were synovectomy under arthroscope.Results The mean follow-up was 14 months,mean Lysholm score improved from 56 7 to 96 2 (P<0 05).Specifically,the pain score improved from 4 3 to 24(P<0 05).All patients were free of pain.Twenty-seven of 34 patients knee had mild chondral damage on the medial femoral condyle.Conclusion We concluded that pathologic hypertrophy of synovium in the anteromedial joint compartment may cause following trauma,causing knee pain.Arthroscopic debridement of this pathologic tissue can significantly improve symptoms.