关节镜下滑膜切除术治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎

目的探讨采用关节镜技术治疗膝关节弥漫型色素沉着绒毛结节性滑膜炎（pigmented villonodular synovitis，PVNS）的方法及疗效。方法26例膝关节弥漫型PVNS患者均行关节镜下滑膜全切除术。术前国际膝关节砰分委员会（IKDC）膝关节功能主观评分为（36．8±4，6）分，Lysholm膝关竹功能评分为（31．7±5．6）分？结果术后均获随访，平均38（13～61）个月。1例患者术后22月复发，再次行关节镜下滑膜切除术。IKDC膝关市功能主观评分为（55．6±3.2）分，Lyshohn膝关节功能评分为（88.5±7.2）分，均明显高于术前（P〈0.01）。结论通过不同天节镜入路，成用刨削器结合等离子汽化技术能够完成膝关节弥漫掣PVNS的滑膜彻底切除，术后近期复发率低，且关节镜下手术具有损伤少、恢复快的优点。

Arthroscopic Synovectomy for Diffused Pigmented Villonodular Synovitis of Knee Joint

Objective To exphwe the method and effect of arthroscopic synovectomy for diffused pigmented vilhmodular synovitis （PVNS） of knee joint, Methods 26 cases suffered diffused PVNS of knee joint were performed arthroscopic total synovectomy and systematic rehabilitation program. The subjective knee function st：ore was 36.8 ±4, 6 according to International Knee Documentation Commiuee（ IKDC） criteria, and the Lysholm Knee Function Score was 31.7±5.6. Results All cases were followed up for 13 to 61 months （ average 38 ）. Only 1 case relapsed at 22 months postoperatively and was cured by reoperation of arthroscopic synovectomy. At the last followed-up, the IKDC Subjective Knee Score was 55.6 ± 3.2 and the l,yshohn Score was 88.5 ± 7.2, and both were obviously improved than that of preoperation （P 〈 0.01 ）. Conclusion Arthroscopic total synovectomy by shaver plus radiofrequency is an effective method for PVNS via different approach with lower recurrence rate in short-term, and the procedure is mini-invasive and easy to restore the knee function.