膝关节弥漫型色素沉着绒毛结节性滑膜炎的关节镜治疗探讨

Treatment of pigmented villonodular synovitis of knee under arthroscopy

摘要：目的探讨关节镜下诊治膝关节弥漫型色素沉着绒毛结节性滑膜炎的方法及疗效。方法对18例膝关节弥漫型色素沉着绒毛结节性滑膜炎患者应用关节镜技术进行检查及治疗，其中11例应用刨削器，7例应用刨削器加射频技术进行滑膜切除．术后进行追踪观察，评定疗效。结果所有患者均行关节镜下滑膜切除、关节腔清理术，11例应用刨削器手术的患者中6例需再次行开放性滑膜大部分切除术，1例再次关节镜手术；7例应用刨削器加射频技术的患者6例经14～42个月追踪复查未见复发，关节功能良好，1例需再次关节镜手术。结论应用关节镜下刨削器结合射频技术全关节腔滑膜切除治疗弥漫型色素沉着绒毛结节性滑膜炎是行之有效的方法．具有操作简单、损伤少、恢复快的优点，近期疗效佳。

Objective To explore the treatment technique of pigmented villonodular synovitis（PVNS） of the knee under arthroscopy and to evaluate its results. Methods Of the 18 cases of knee PVNS treated by arthroscopic total synovectomy, there were 11 cases with shaver and 7 cases with shaver plus radiofrequency technique. The patients were followed up for 14 to 42 months. Resuits Among the 11 cases who were conducted total synovectomy by shaver, there were 6 recrudescent cases acquired open total synovectomy, 1 recrudescent cases acquired arthroscopic total synovectomy again. Among the 7 cases who were conducted total synovectomy by shaver plus electrofrequence technique, there was 1 recrudescent cases, no recurrences was found in 6 cases during the followed up period. Conclusion Arthroscopic total synovectomy by shaver plus radiofrequency is a effective method to treat PVNS. The procedure is minimal invasive , easy to manipulate and useful to restore knee function.