股骨髁间窝非骨性撞击综合征临床诊治15例报告

The Diagnosis and Treatment of Femoral Intercondylar Notch Non-Bony Impingement Syndrome:15 Cases Report

目的：回顾性分析总结股骨髁间窝非骨性撞击综合征病例的临床特点,探讨诊断及治疗方案。方法：2004年10月至2007年12月对膝关节伸直受限的115例患者（120膝）行关节镜手术,依据镜下检查筛选出股骨髁间窝非骨性撞击综合征患者15例,其中半月板桶柄状裂伤3例,前交叉韧带囊肿1例,前交叉韧带胫骨止点部分损伤3例,滑膜嵌顿3例,滑膜软骨瘤病5例;术前9例患者经MRI明确诊断,2例经X线明确诊断;15例均经关节镜检查得以确诊。结果：手术治疗15例患者（15膝）,术后均得到随访,随访时间4-24个月,平均13个月。Lysholm评分术前平均65分（41-75分）,术后平均89分（75-100分）。术前伸膝受限5-25度（平均8.1度）,术后伸膝受限0度（均为0度）。结论：关节镜检查可准确诊断股骨髁间窝非骨性撞击综合征,术前MRI有助于诊断,X线片和MRI阴性者行诊断性关节镜检查;关节镜手术治疗可以获得满意的主、客观疗效。

Objective To summarize clinical features and explore diagnosis and treatment of femoral intercondylar notch non-bony impingement syndrome.Methods 15 patients of femoral intercondylar notch non-bony impingement syndrome were identified during arthroscopic operation of 115 patients（120 knees） with restricted knee joint extention during Oct 2004 to Dec 2007.Among these 15 patients,there were 3 cases of Bucket Handle Tear（BHT）,1 case of ACLs’ cyst,3 cases of ACL tibial avulsion injury,3 cases of synovial incarceration,and 5 cases of synovial chondroma.9 patients were diagnosed by MRI and 2 by X-ray before operation.All 15 patients were confirmed under arthroscopy.Results 15 patients（15 knees）were operated and followed up for a period of 4～24 months,mean 13 months.Mean Lysholm score was 65（range,41～75）before operation and 89（range,75～ 100）after operation.Joint extension restrict was 5～25 degrees（mean 8.1 degree）before operation and 0 degree after operation.Conclusion Arthroscopy could accurately diagnose femoral Intercondylar notch non-bony impingement syndrome.Pre-operation MRI was helpful for diagnosis.If MRI and X-ray showed negative findings,diagnostic arthroscopic examination could be applied.Good subjective and objective effects could be achieved with arthroscopic operation.