关节镜结合放射治疗膝关节色素沉着绒毛结节性滑膜炎

Arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee

[目的]探讨采用关节镜结合放射治疗膝关节色素沉着绒毛结节性滑膜炎的方法及其临床应用价值。[方法]2000年1月～2003年7月,共收治14例膝关节色素沉着绒毛结节性滑膜炎患者,采用关节镜下常规器械加双极射频进行关节内病变切除,术后弥漫性色素沉着绒毛结节性滑膜炎辅以放疗,13例通过10～45个月的随访,了解患膝活动度、疼痛、肿胀情况。[结果]13例随访患者,术前国际膝关节评分委员会(IKDC)膝关节功能主观评分为(58.7±6.4)分,最后随访时,IKDC膝关节功能主观评分为(86.5±5.7)分。[结论]通过关节镜能完成膝关节色素沉着绒毛结节性滑膜炎滑膜较彻底切除,对弥漫性膝关节色素沉着绒毛结节性滑膜炎辅以术后放疗是一种有效方法。

[ Objective ] To explore the technique of arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee and to evaluate its clinical value. [ Method] A total of 14 cases of pigmented villonodular synovifis of the knee were treated from January 2000 to July 2003. Intra-artieular excision under arthroscope with a combined application of routine intrusments and Bipolar radiofrequeney was performed on all these 14 cases, and postoperative radiotherapy for diffused pigmented villonodular synovitis of the knee, 13 patients were followed up for 10 - 45 months, and were evaluated for range of motion, pain, swelling effusion. [ Result ] Thirteen cases according to the International Knee Documentation Committee （IK- DC） criteria, subjective knee score was （58. 7±6. 4） and （86. 5±5.7） respectively before surgery and at the last follow-up. [ Condusion] In case of pigmented villonodular synovitis of the knee joint, arthroseopieal synovectomy can make good surgical results, and postoperative radiotherapy is an effective treatment for diffused pigmented vilionoclular synovitis of the knee.