关节镜检查和镜下手术诊治膝关节内良性肿瘤

Arthroscopic diagnosis and treatment of benign tumor in the knee joints

[目的]提高对膝关节内良性肿瘤诊断的认识和探讨镜下手术适应证的选择。[方法]回顾总结1996年以来关节镜检查确诊并同时进行镜下手术治疗的13例膝关节内良性肿瘤的患者,其中男9例,女4例;年龄7～49岁,平均38.2岁。滑膜血管瘤3例,腱鞘巨细胞瘤2例,十字韧带腱鞘囊肿或滑膜囊肿4例,软组织内软骨瘤1例,十字韧带内韧带状瘤2例,十字韧带内硬纤维瘤1例。经过至少半年以上随访,进行疗效观察。[结果]全部病例均在膝关节镜检查后确诊,并经过病理证实。镜检后同时行关节镜下手术治疗,随访11个月～6年,术后较之术前临床症状明显改善,无复发。疗效评定:优46%,良39%,可15%。[结论]膝关节内良性肿瘤少见,单凭临床诊断较为困难,极易漏诊。对于临床上不确切的膝关节紊乱病人,MRI有助于鉴别诊断,关节镜检查和镜下手术是确诊和治疗的主要手段。

[Objective] To enhance the understanding of the diagnosis of benign tumor in the knee joints. [ Method] Thirteen patients （9 males and 4 females, aged 7 to 49 years , 38. 2 years arerage） with tumor in the knee joints were diagnosed and treated under arthroscopy since 1996. There were 3 with the synovial hemangioma, 2 with tensoynovial giant cell tumor, 4 with ganglion cysts of cruciate ligament and synovial cysts, 1 with chondroma in the soft tissue, 2 with desmoid tumor in the cruciate ligament and 1 with cruciate ligament desmoid. The curative effects were observed through a follow - up of more than half a year. [ Result] All the cases were diagnozed under arthroscope and confirmed by the pathological examinations. All the patients were treated under arthroscope and followed by 11 months to 6 years. Clinical symptom improved obviously and no recurrence was found after the operation. Assessment of the curative effects were 46% excellent, 39% good and 15% fair. [ Conclusion ] Benign tumor in the knee joints is rare. It＇ s often difficult to diagnoze in the clinical practice. Arthroscopy is a very useful method for the diagnosis and treatment of the suspected patients with benign tumor in knee joints.