误诊为半月板损伤的弹响膝122例分析

Etiological analysis and arthroscopic treatment of snapping knees which were preoperative misdiagnosised as meniscus injury

目的探讨误诊为半月板损伤患者弹响膝的发生机制、临床表现、诊断和关节镜治疗。方法回顾性分析122例术前误诊为半月板损伤的弹响膝患者资料,所有患者均接受膝关节镜手术。分析不同病因导致膝关节弹响的部位、响度、发生频率、镜下表现,最终评价关节镜手术疗效。结果许多疾病均可出现膝关节弹响,最常见原因为半月板损伤,其次是关节内游离体、软骨病变、滑膜病变、髌股关节紊乱、韧带及肌腱损伤等。其弹响各有特点,关节镜诊治后91.8%弹响症状完全消失,少数患者残余部分症状。结论膝关节弹响来源多样,半月板源性的弹响最为常见。掌握弹响特点有助于术前正确诊断,提高手术疗效,避免过度医疗。关节镜手术是诊治弹响膝的金标准。

Objective To find out helpful clinical characteristics of snapping knees which were preoperative misdiagnosis as meniscus injury, and evaluate arthroscopic treatment. Methods 122 cases underwent arthroscopic treatment were studied retrospectively, all these cases were preoperative misdiagnosised. Results The snapping causes were varied, which included meniscal tears and cyst,discoid meniscus, osteoarthritis, synovial plica, loose body, disorder of patellofemoral joint, osteochondrosis dissecans, pigmental villonodular synovitis, popliteal tendon and cruciate ligament injuries, etc. The characteristics of snapping knee were different depending on different causes. 91.8% cases had an excellent result based on Lysholms scoring scale. Conclusions The major causes of snapping knees are meniscal tears and discoid meniscus. The characteristic knowledge of snapping knees is helpful to accurate diagnosis. Arthroscopy technology plays an important role in diagnosis and treatment of snapping knees.