关节镜诊治膝关节十字韧带区囊肿7例报道

Diagnosis and treatment of cruciate ligament ganglion cysts by arthroscopic surgery:a series of 7 cases

目的回顾性总结并探讨7例膝关节十字韧带区囊肿病例的临床特点及诊治方法。方法2006年5月至2008年8月,共收治膝关节十字韧带区囊肿患者7例,男5例,女2例;年龄17岁～46岁,平均34岁;左膝4例,右膝3例。所有患者均通过MR检查确诊,并行关节镜检查及治疗。手术前、后采用Lysholm评分和手术后疗效评定的Glasgow评定法对关节镜手术治疗膝关节十字韧带区囊肿的结果进行评价。结果全部获得随访,随访时间9～26个月,平均13.6个月。7例患者均无复发,患者关节活动范围正常,无屈膝疼痛,均达到完全治愈。手术前Lysholm评分为(78.5±7.1)分,手术后3个月提高至(92±2.5)分(P<0.01)。7例患者Glasgow疗效评定均为优。结论膝关节十字韧带区囊肿的典型特点:膝关节屈伸运动到某一固定角度突发膝关节疼痛。MR检查和关节镜检查对于诊断膝关节十字韧带区囊肿最具特异性。关节镜检查可明确诊断,并可同时镜下行手术切除治疗,首选治疗方式为关节镜下膝关节十字韧带区囊肿切除。

Objective To summarize the diagnosis and treatment of cruciate ligament ganglion cysts of the knee joint of 7 cases with arthroscopy. Methods From May 2006 to August 2008, 7 patients with cruciate ligament ganglion cysts of the knee were involved in this study. Thre were 5 male and 2 female, aged from 17 to 46 years old with an average of 34 years. Illness was lacated on the left knee in 4 cases and on the right knee in 3 cases. All the cases were diagnosed by physical examination and MRI, and excised with a_rthroscopic technique. Lysholm scoring scale system was used to evaluate the knee function before and after operation, and Glasgow cyst grading system was used to evaluate the final follow - up results. Results A follow - up of 9 to 26 months in an average of 13. 6 months showed good joint fimction for all the patients and no sign of recurrence at the last follow - up. Lysholm score is improved from 78. 5±7. 1 preoperatively to 92 ±2. 5 three months after operation, and the statistical difference is very significant （P 〈 0. 01 ）. And curative effect was evaluated well by Glasgow system. Conclustion MRI scan and arthroscopy have specificity in diagnosis of cruciate ligament ganglion cysts of knee. Arthroscopy can make a definite diagnosis and be used as the first choice of treatment for this rarely encountered disorder.