化脓性膝关节炎的关节镜治疗

The Treatment of Septic Knee with Help of Arthroscopy

目的:介绍关节镜下冲洗清理术在早期化脓性膝关节炎治疗中的应用。方法:在关节镜下行关节冲洗清理术治疗化脓性膝关节炎24例,术后直接关闭缝合,置引流24～48h;同时给予全身抗生素的应用,支具伸直位固定3周,行关节功能康复训练。通过体温、皮温、关节是否肿胀,浮髌征,关节活动度来评价该方法的疗效。结果:术后1～3d,体温恢复正常。术后8周,关节肿胀消失,浮髌征阴性,无伸膝功能障碍,屈膝活动度超过120°。结论:关节镜下冲洗清现术治疗早期化脓性膝关节炎具有损伤小,患者痛苦小,恢复快,关节功能恢复满意优点。

Objective：To introduce a technique to treat the inchoate septic knee by debridement with help of arthroscopy.Methods： Twenty four cases of septic knee received the joints debridement under arthroscopy. The lacerations were straightway stitched and then the drainage tubes were retained for 24 - 48 hours. Meanwhile, the antibiotics were intravenously administered. The knee joints were fixed in stretching position by means of orthosis for 3 weeks. The joint functional rehabilitation training was simultaneously undertaken. The clinical effect was evaluated by body temperature, skin temperature, joint range of motion, with or without arthrocele and floating patella phenomenon. Results： The body temperature returned to normal score on the first to third day after operation. After postoperative eight weeks, the swelling of knee joints disappeared, negative floating patella phenomenon, without functional impairment of stretching knee,the range of genuflex motion beyond 120 degrees. Conclusions： The inchoate septic knee debrided under arthroscopy could improve quickly, with little damage, slight painful and satisfactory joint functional recovery.