摘要
背景:骨软骨瘤是临床最常见的良性骨肿瘤,传统开放性手术术后并发症发生率高。目的:探讨关节镜下切除膝关节外骨软骨瘤的临床疗效。方法:回顾性分析2010年8月至2018年8月采用关节镜治疗的74例膝关节外骨软骨瘤患者。其中股骨远端26例,胫骨近端48例。术前常规行膝关节X线、CT及MRI检查,术前及术后3个月、6个月、12个月及末次随访时采用疼痛视觉模拟评分(VAS)及Lysholm评分、国际膝关节文献委员会(IKDC)评分、Tegner膝关节运动功能评分评估膝关节症状和功能。结果:74例患者病程3~14个月,平均(7.9±3.7)个月。随访时间24~37个月,平均随访(32.6±6.4)个月。所有患者均未出现血管、神经损伤及伤口感染。末次随访时患者疼痛VAS评分、Lysholm评分、IKDC评分、Tegner评分均较术前改善[(0.1±0.02)分vs(3.6±1.1)分,(91.3±4.9)分vs(44.5±2.3)分,(94.2±5.1)分vs(53.7±2.6)分,(9.4±1.4)分vs(4.6±1.2)分],且差异均有统计学意义(P均<0.001)。所有患者随访期间肿瘤均未复发或转移。结论:关节镜下切除膝关节外骨软骨瘤能够显著改善患者膝关节症状和功能,具有创伤小、精度高、疼痛轻及恢复快的优点,可逐步尝试并推广至其他良性骨肿瘤的治疗。
Background:Osteochondroma is the most common benign bone tumor in clinic.Open surgery has a high incidence of postoperative complications.Objective:To investigate clinical outcomes of arthroscopic resection of extraarticular knee osteochondroma.Methods:A retrospective analysis was performed in 74 patients with extra-articular knee osteochondroma treated by arthroscopic resection between August 2010 and August 2018.Distal femur was involved in 26patients and proximal tibia was involved in 48 patients.X-ray,CT and MRI were performed before the operation.The Lysholm knee score,International Knee Documentation Committee(IKDC)score,Tegner knee motor function score and visual analogue scale(VAS)were used to evaluate symptoms and functions before surgery and 3,6,12 and≥24 months after surgery.Results:The mean course of disease was(7.9±3.7)months(range,3-14 months)in the 74 patients.The mean follow-up period was(32.6±6.4)months(range,24-37 months).None had vascular,nerve injury or wound infection.Compared with preoperative ones,the average scores of VAS,Lysholm,IKDC and Tegner joint motor function improved significantly at the last follow-up(3.6±1.1 vs 0.1±0.02,44.5±2.3 vs 91.3±4.9,53.7±2.6 vs 94.2±5.1,4.6±1.2 vs 9.4±1.4,P<0.001).No recurrence or metastasis occurred during follow up.Conclusions:With the advantages of less trauma,high precision,less pain and rapid recovery,arthroscopic resection of osteochondroma can significantly improve the function of knee joint.It can be gradually extended to the treatment of other benign bone tumors.
作者
陈鹏
张新涛
白露
任玉香
张文涛
CHEN Peng;ZHANG Xintao;BAI Lu;REN Yuxiang;ZHANG Wentao(Institute of Sports Medicine,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China)
出处
《中华骨与关节外科杂志》
2021年第7期616-620,共5页
Chinese Journal of Bone and Joint Surgery
基金
深圳市医疗卫生三名工程项目(SZSM201612078)
关键词
关节镜
膝关节外
骨软骨瘤
Arthroscope
Extra-articular Knee
Osteochondroma
