关节镜下治疗腘窝囊肿35例报道

Arthroscopic Treatment of Popliteal Cyst

目的:探讨关节镜技术治疗腘窝囊肿的方法及其临床疗效。方法:2002年10月至2004年7月,采用关节镜技术对35例腘窝囊肿患者进行治疗,其中男性14例,女性21例,年龄42～68岁,平均49.7岁。窝囊肿均为单侧,其中右膝16例,左膝19例。在处理关节内疾患的同时,在后内侧间室扩大窝囊肿与关节腔之间的通道口。4例巨大囊肿(直径>5cm)同时行后路关节镜下囊壁切除术。根据Rauschning和Lindgren分级方法评定手术效果。结果:本组35例腘窝囊肿患者在术中均可发现伴有关节内疾患,其中内侧半月板撕裂24例,外侧半月板撕裂7例,前交叉韧带撕裂4例,骨性关节炎27例,痛风性关节炎1例。术后未出现血管、神经或手术切口并发症。术后2～3天出院。随访时间6～29个月,平均11个月,94.2%的病例未出现囊肿复发。Rauschning和Lindgren分级结果:术前Ⅰ级4例,Ⅱ级12例,Ⅲ级19例;术后0级30例,Ⅰ级4例,Ⅱ级1例。结论:关节镜下治疗窝囊肿具有创伤小、恢复快、复发率低的优点。

Objective To evaluate the results of arthroscopic treatment of popliteal cyst. Methods From October 2002 to July 2004, 35 patients with popliteal cysts were treated by arthroscopy, including 14 males and 21 females with average age of 49.7 years ranging from 42 to 68 years. The popliteal cysts were unilateral, including 16 at the right knee and 19 at left knee. During operation, the intra- articular pathology was corrected and the connecting hole between popliteal cyst and joint space were enlarged. The capsule was removed in 4 large cysts （about 5cm in diameter）under arthroscopy. All patients were followed up for 11 months averagely （from 6 to 29 months）. Results All patients were revealed intra - articular pathology, including medial meniscus tears in 24 cases, lateral meniscus tears in 7 cases, ACL tears in 4 cases, and osteoarthritis in 27 cases, gouty arthritis in 1 cases. No complication of blood vessel, nerve, or incision occurred and all patients were exchanged 2 or 3 days postoperatively. According to the guidelines of Rauschning and Lindgren, there were 4 cases of gradeⅠ , 12 cases of grade Ⅱ and 19 cases of grade m before surgery. After surgery, there were 30 cases of grade 0, 4 cases of grade Ⅰ and 1 cases of grade Ⅱ . Conclusion The arthroscopic treatment of popliteal cyst has the advantages of mini - invasive, fast - recover, and low recurrence.