摘要
目的探讨关节镜下滑膜切除治疗膝关节色素沉着绒毛结节性滑膜炎（pigmented villonodular synovitis，PVNS）的疗效。 方法回顾分析2008年6月－2011年12月13例膝关节PVNS患者临床资料。男9例，女4例；年龄25～45岁，平均33岁。左膝8例，右膝5例。其中5例有明确外伤史，8例无外伤史。病程4～80个月，平均44个月。术前Lysholm评分为（45.3 ± 4.2）分，国际膝关节文献委员会（IKDC）2000评分为（46.8 ± 4.9）分。患者均于关节镜下切除滑膜， 术后进行放疗。 结果病理检查均确诊为PVNS。术后患者切口均Ⅰ期愈合，无血管、神经损伤及膝关节感染等并发症发生。术后均获随访，随访时间12～30个月，平均21.8个月。末次随访时，Lysholm评分为（90.2 ± 7.4） 分，IKDC2000评分为（87.8 ± 3.8）分，均较术前显著提高（t=22.64，P=0.00；t=24.32，P=0.00）。随访期间均无复发。 结论关节镜下滑膜切除可有效治疗膝关节PVNS，手术创伤小，关节功能恢复快，疗效满意，是一种安全、可行的微创治疗方法。
ObjectiveTo explore the effectivness of arthroscopic synovectomy in the treatment of pigmented villonodular synovitis （PVNS） of the knee. MethodsA retrospective analysis was conducted on 13 patients with PVNS of the knee treated with arthroscopic synovectomy between June 2008 and December 2011, including 8 left knees and 5 right knees. There were 9 males and 4 females, aged 25-45 years （mean, 33 years）. Of 13 patients, 5 had a history of trauma, and 8 had no history of trauma. The disease duration ranged from 4 months to 80 months （mean, 44 months）. The preoperative Lysholm score was 45.3 ± 4.2, and International Knee Documentation Committee （IKDC） 2000 score was 46.8 ± 4.9. All patients underwent arthroscopic synovectomy and postoperative radiotherapy. ResultsThe pathological examination proved PVNS in all cases. All incisions obtained healing by first intention after operation. There was no neurovascular injury or knee infection. The average follow-up period was 21.8 months （range, 12-30 months）. The Lysholm score was 90.2 ± 7.4, and IKDC2000 score was 87.8 ± 3.8 at last follow-up, showing significant differences when compared with preoperative scores （t=22.64, P=0.00; t=24.32, P=0.00）. No recurrence was observed during follow-up. ConclusionArthroscopic synovectomy can be effective in the treatment of PVNS of the knee, and it has the merits of minimal invasion, rapid function recovery of the knee joint, and satisfactory results. So it is a safe, promising, and minimal invasive procedure in treatment of PVNS.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2013年第10期1171-1174,共4页
Chinese Journal of Reparative and Reconstructive Surgery
