关节镜下诊治人工膝关节置换术后痛性弹响3例并文献复习

Arthroscopy in Diagnosis and Treatment of Postoperative Painful Snapping Knee After Total Knee Arthroplasty:A report of three Cases with Review of the Literature

目的探讨膝关节镜在人工膝关节置换术后痛性弹响中的应用价值。方法在人工膝关节置换术后疼痛伴有弹响的患者中，选择没有明显骨质破坏、假体没有松动的患者3例，在硬膜外麻醉下行关节镜检查，镜下发现膝关节内有增生的纤维结节及纤维束带，动态检查发现关节痛性弹响系增生的纤维束和纤维结节受到卡压所致，行关节镜下清理术。结果3例患者手术后关节疼痛及弹响症状消失．随访0．5～2年无复发，手术前患者的HSS评分为64分（62～70分），手术后增加到86分（84～88分），结论关节镜下对人工膝关节置换术后痛性弹响的患者进行关节清理术有较好的疗效，是一种创伤小、风险小、治疗效果满意的诊治方法。

Objective To investigate the application value of arthroseopy in painfnl snapping knee after total knee arthroplasty. Methods Among patients with painful snapping knee after total knee arthroplasty, three cases without obvious bone destruction and loosening of prosthesis were given with arthroseopy under epidural anesthesia. Nodular hyperplasia of fiber and fiber band were found in the knee and painful snappings were produced by the compression of hyperplasia of fiber and fiber band under dynamic examination. Meanwhile arthroscopic debridement wsa made. Results The symptoms of painful snapping of three easea disappeared after surgery And 0.5-2 years of follow-up, there is no recurrence, patients＇ HSS score is 64 points （62-70） before surgery and patients＇ HSS score rise to 86 points （84-88 points ） after surgery. Conclusion Arthroscopie debridement has good effects in treatment of those patients with painful snapping knee after total knee arthrosplasty,which is a kind of method of diagnosis and treatment with minimally invasion, less risk and satisfied effects.