关节镜下钬激光治疗膝关节疾病(附37例报告)

Ho: YAG laser operations under the arthroscope for knee diseases (a report of 37 cases)

目的探讨关节镜下钬激光治疗膝关节疾病的临床疗效。方法2006年1月～2008年1月在关节镜下用钬激光治疗各类膝关节疾病37例,男16例,女21例,年龄17～67岁,平均42.3岁。其中半月板破裂18例,盘状半月板5例,骨性关节炎软骨退变11例,髁间棘骨折伴交叉韧带损伤3例。观察手术前后的Lysholm膝关节评分、手术时间、下床时间、术后关节积液及并发症的发生率。结果全部手术均顺利完成,手术时间20～55min,平均37min,术后下床时间1～4d,平均2.1d,术中未发生血管神经损伤及与器械相关的并发症。术后切口均一期愈合,37例患者得到6～21个月随访,平均随访11.3个月,按照Lysholm膝关节评分法,关节镜下钬激光治疗膝关节内疾病的总优良率达92.1%。结论关节镜下钬激光治疗膝关节内疾病操作简单、方便,术中创伤小、并发症少,术后康复快,是治疗膝关节内疾病的良好选择。

[ Objective] To explore the effect of holmium： YAG laser operation under arthroscope for knee diseases. [Methods] Thirty-seven cases of knee diseases were treated by holmium： YAG laser under knee arthroseope from Jan 2006 to July 2008 and follow-up was finished. There were 16 women and 21 men with the average age 42.3 years （17 - 67 years）. Among the patients, 18 were menisci tears, 5 were discoid menisci, 11 were osteoarthritis with cartilage degeneration and 3 were tibial intercondylar eminence fracture with cruciate ligament damage. Pre- and post-operation Lysholm knee score, operation time, off-bed activity time and complications were recorded. [ Results ] All the operations were successful. The average operation time was 37 minutes （20-55 minutes）. The average off-bed activity time was 2.1 days （1-4 days）. With mean follow- up of 11.3 months （ranged 6-21 months）, none of 37 cases experienced synovitis or hydroarthrosis postoperatively. According to Lysholm knee score, the total fine rate was 92.1%. [ Conclusion] Ho： YAG laser is a safe, simple, effective tool in treating knee diseases under arthroscope.