关节镜下治疗半月板内型囊肿的临床观察

ARTHROSCOPIC TREATMENT OF INTRA-ARTICULAR MENISCAL CYSTS

目的探讨关节镜下治疗半月板内型囊肿的方法及疗效。方法2005年1月-2009年12月,对9例半月板内型囊肿患者于关节镜下行切除囊肿治疗。其中男5例,女4例;年龄24～46岁,平均33.8岁。左膝6例,右膝3例。1例有明确外伤史,其余患者均无明显诱因。Lysholm评分为(74.2±11.6)分。病程4～36个月,平均24.2个月。关节镜下见8例囊肿位于外侧半月板,1例位于内侧半月板;均位于半月板前角;囊肿均为单发,其中3例为多房。结果术后切口均Ⅰ期愈合,无关节感染及关节腔积液等并发症发生。术后9例均获随访,随访时间3～48个月,平均12.7个月。患者术前症状消失或明显减轻,关节活动度恢复正常。术后3个月Lysholm评分为(95.1±3.4)分,与术前比较差异有统计学意义(P<0.01)。采用Choy等评定标准进行疗效评定,获优6例,良2例,可1例,优良率为88.9%。随访期间囊肿均无复发。结论关节镜下切除半月板囊肿具有创伤小、恢复快、治疗彻底、不易复发等优点,还可同时行半月板修复或部分切除等手术,是治疗半月板内型囊肿的有效方法之一。

Objective To investigate the treatment and therapeutic efficacy of intra-articular meniscal cysts by arthroscopy. Methods From January 2005 to December 2009,9 cases of intra-articular meniscal cysts were treated by arthroscopy,including 5 males and 4 females,with an average age of 33.8 years （range,24-46 years）. Six patients suffered in left knees,3 in right ones. Just 1 case had trauma history,the others had no obvious predisposing causes. The average course of the disease was 24.2 months （range,4-36 months）. The Lysholm score was （74.2 ± 11.6） points. Arthroscopy showed that the locations of cysts were the anterior horn of lateral meniscus in 8 cases and the anterior horn of medial meniscus in 1 case; all being single cyst （of them,3 being multilocular cyst）. Results All incisions healed primarily with no complications of infection and joint effusion. All 9 patients were followed up from 3 to 48 months with an average of 12.7 months. Preoperative symptoms disappeared or reduced and the range of motion of the knee returned to normal. The Lysholm score was （95.1 ± 3.4） points after 3 months of operation,showing significant difference （P 〈0.01） when compared with the socre before operation. According to assessment standard described by Choy,the treatment outcome was excellent in 6 cases,good in 2 cases,and general in 1 case; the excellent and good rate was 88.9%. No recurrence was found during follow-up. Conclusion Arthroscopic surgery shows the advantages to maintain good function of knee for the treatment of meniscal cyst,it is the best choice for intra-articular meniscal cysts because of its mini-trauma,rapid recovery,thorough treatment and less recurrence. Simultaneously,partial or tatol meniscectomy or menicus repairing under arthroscopy is performed.