关节镜下关节内外粘连松解术治疗屈膝功能障碍的方法探讨

Arthroscopic treatment of flexion deficient knee by intra/extra-articular fibrosis release

目的探讨采用关节镜下松解膝关节内、外粘连所致的屈膝功能障碍的治疗方法和疗效。方法对2002年元月至2004年12月间膝关节手术后屈膝功能障碍的67例患者行粘连松解术,在关节镜下采用钩刀、刨刀、射频切除关节内髌上囊、内外侧间隙、髌下脂肪垫间隙、髁间窝等和关节外的股骨与股中间肌间隙、股内外侧肌间隙的粘连以及配合手法进行松解和术后康复治疗。结果67例患者随访6～12个月(平均10.4个月),屈膝活动度增强30°～80°(平均78.26°),膝关节Ly-sholm功能评分术前(56.60±7.20)分,术后(84.40±11.20)分(t=2.68,P<0.01)。结论关节镜下行关节内外粘连松解术治疗屈膝功能障碍有效、创伤小、恢复快。

Objective To investigate the methods and results of arthroscopic treatment of flexion deficient knee by intra/extra-articular fibrosis release. Methods Sixty-seven patients with flexion defi- cient knee accepted arthroscopic release from January 2002 to December 2004. Fibrosis in suprapatellar pouch,lateral/medial gutter, infrapatellar pad, intercondylar notch, and extra-articular such as the fibrosis between intermedius, vastus medialis/lateralis and femur were released by knife, shaver and electrocautery arthmscopicly. Results After the treatment sixty-seven patients with flexion deficient knee had been fol- lowed for six to twelve months with an average of 10. 4 months. The addition of their range of flexion varied from 30° to 80° with an average of 78.26°. The results of arthroscopic treatment were better than non-arthroscopic ones. Conclusion Arthroscopic fibrosis release of flexion deficient knee is worth generalizing for its effectiveness and mini-invasive.