关节镜下微创松解治疗伸膝装置挛缩疗效观察

目的探讨伸膝装置挛缩所致膝关节功能障碍,行关节镜下微创松解的方法及疗效。方法本组22例单膝功能障碍患者,男18例,女4例,年龄25～66岁。关节僵硬病因包括股骨、髌骨及胫骨骨折术后,膝关节内复合伤术后,交叉韧带重建术后和化脓性膝关节炎,病程6～32（平均18）个月。术前膝关节活动度45°～95°,平均80°,均行关节镜下膝关节内粘连松解或（和）小切口伸膝装置松解术。结果手术时间45～90（平均60）min。术后无感染、重要血管神经损伤及关节失稳等并发症。随访9～24（平均12）个月,术后膝关节活动度100°～130°,平均增加75°,膝关节功能和步态明显改善,能满足日常生活和工作需要。结论关节镜下微创松解治疗伸膝装置挛缩所引起的膝关节僵硬,具有创伤小、康复快、效果好、并发症少等优点,是膝关节僵硬首选的治疗方法。

The Treatment of Contracture of Extended Knee Structure Under Microinvasive Arthroscope

Objective To explore the method and effect of arthroscopic arthrolysis in the treatment of disfunction of knee joint resulted from contracture of extended knee structure. Methods Twenty-two patients （18 males,4 females） in our group, The ages of the patients ranged from 25 to 66 years,and the disfunction involved in only one knee. The pathogeny of ankylose including postoperation of the fractures of femur, patella and tibia; complex inju ries of knee; cruciates ligament reconstruction,and suppurative arthritis. The duration was 6 to 32 months, mean 18 months. The flexibility of knee 45°to 95° preoperatively, the mean 80°. All of the cases were treated with arthroscopic release and/or extended knee structure release with small incision. Results The operation time was 45 to 90 min, mean 60 min. No complications such as infection, important nerves and vessels injured, and joint instability happened. Followed up for 9 to 24 months, mean 12 months. The flexibility of knee 100° to 130°postoperatively, the mean 75°, function and gait of knee were marked improved, which can meet their daily lives and work demand. Conclusion Extended knee structure adhesion lysis under arthroscope is a minimal invasive operation with soon recovery and good effect.