关节镜下治疗膝关节色素绒毛结节性滑膜炎

目的探讨关节镜下治疗膝关节色素绒毛结节性滑膜炎的治疗效果。方法采用关节镜下滑膜切除术治疗膝关节色素绒毛结节性滑膜炎患者24例,其中弥漫型19例,局限型5例。术后平均随访时间25个月(12￣56个月),按照Ogilvie-Harris膝关节评分进行临床评价。结果弥漫型色素绒毛结节性滑膜炎组术前平均(3.47±2.20)分,术后(10.05±2.04)分。局限性色素绒毛结节性滑膜炎术前平均(5.40±1.52)分,术后平均(11.80±0.45)分。局限性结节型色素绒毛结节性滑膜炎组,术后开始结果为优,未见复发病例;弥漫型色素绒毛结节性滑膜炎组术后即刻结果75.0%(18例)为优,21.0%(5例)为良,4.0%(1例)为可,术后2a复发12.5%(3例)。该组病例无任何并发症发生。结论关节镜下滑膜切除术治疗膝关节色素绒毛结节性滑膜炎并发症发生率低、侵袭小、术后功能恢复快。

Arthroscopic treatment of pigmented villonodular synovitisof the knee

Objective] To evaluate the effects of arthroscopic treatment of pigmented villonodular synovitis(PVNS) of the knee. Methods] 24 cases of pigmented villonodular synovitis of the knee were treated by arthroscopic synovectomy. The patients were followed up for 12 to 56 months, and were evaluated according to Ogilvie-Harris scoring scale. Results] All 24 patients were available for follow-up. The group of patients of diffuse PVNS treated with extensive synovectomy improved from an average preoperative score of 3.47 points to an average postoperative 10.05 points. The group of patients of localized (nodular) PVNS improved from an average preoperative score of 5.40 points to an average postoperative 11.8 points. In cases of nodular disease, the result was excellent from the beginning; no recurrence was seen. For patients of diffuse PVNS, immediate excellent results were seen in 75%(18 cases)of cases, 21% (5 cases)good, 4%(1 case) fair. In 12.5% (3 cases) of the cases recurred in the 2 years after operation. Conclusions] Using arthroscopic synovectomy to treat knee PVNS has the advantages of less complications, less invasion, rapid function recovery, and low recurrence.