膝关节局灶型滑膜巨细胞瘤关节镜手术治疗5例

Five cases arthroscopic treatment of the giant cell tumor of tendon sheath in knee joint

目的探讨膝关节内局灶型滑膜巨细胞瘤的关节镜治疗。方法总结2005年1月至2007年12月收治膝关节局灶型滑膜巨细胞瘤患者5例,5例全部通过病理学检查确诊,术前误诊半月板损伤2例,膝关节慢性滑膜炎2例,滑膜皱襞增生1例。全部病例均采用关节镜下肿瘤完整切除术。结果5例患者获得1～3年随访,临床症状消失,膝关节活动正常,X线检查未见异常,无复发病例。结论膝关节镜下手术治疗滑膜巨细胞瘤是较佳方法,术中行瘤组织周围扩大切除及肿瘤取出组织通道处刨削清理,是防止肿瘤复发的关键所在。

Objective To explore the technique of diagnosis and treatment of intra-articular giant cell tumor of synovia in knee joint. Methods Five patients with GCTTS treated during 3 years were reviewed.Five cases were misdiagnosed with meniscus injury （2 cases） and chronic synovitis （2 cases） before operation.Complete tumorectomy under arthroscope was performed on all 5 cases. Results The results of clinical and radiographic followed-up of 5 patients for 1 to 3 years after operation was satisfactory. Clinical symptoms disappeared, range of motion and X-ray findings were normal. There was no recurrent case found. Conclusions Arthroscopie removal of GCTTS is an effective treatment.Tumor wide resection and debriding the channel which tumor passed through are the key point to prevent the recurrence after operation.