关节镜下与开放手术治疗膝关节色素沉着绒毛结节性滑膜炎的疗效比较

Comparison of the Efficacy of Arthroscopic Surgery vs Open Surgery for the Treatment of Pig- mented Villonodular Synovitis of the Knee

【目的】探讨关节镜下和开放手术两种方法在治疗色素沉着绒毛结节性滑膜炎（PVS）疗效差异及优缺点。【方法】收集本院2006年6月至2010年6月就诊的并经确诊PVS的患者共36例。患者随机分为两组，每组18例，A组行关节镜治疗，B组行常规切开手术治疗，记录两组患者手术时间、出血量、术中引流量以及术前术后膝关节活动度，并采用Lysholm评分评估膝关节功能。【结果】A组患者手术时间、出血量及引流量显著低于B组，差异有统计学意义（P〈0．05）；A组术后3个、12个月膝关节活动度改善优于B组，差异有统计学意义（P〈0．05）；两组患者术后膝关节Lysholm评分均有明显改善，但3、12个月Lysholm评分A组优于B组，差异有统计学意义（P〈0．05）。【结论】相对于传统开放性手术，关节镜下治疗PVS具有创伤小、出血少、可最大限度恢复膝关节功能等特点，有较高临床应用价值。

[Objective] To explore the differences of the efficacy, advantages and disadvantages between arthroscopic surgery and open surgery for the treatment of pigmented villonodular synovitis（PVS） of the knee. [Methods] Thirty six cases diagnosed as PVC in our hospital from June 2006 to June 2010 were collected. All patients were randomly divided into two groups with 18 cases in each. Group A underwent arthroscopic treatment and group B underwent open surgery. The operation time, bleeding volume, intraoperative drainage volume and preoperative and postoperative knee joint motion of the patients in two groups were recorded. Lysholm score was used to evaluate the knee joint function. [Results] The operation time, bleeding volume and drainage volume in group A were lower than those in group B, and there was significant difference（ P 〈0. 05）. The improvement of knee joint motion in group A was better than that of group B, and there was significant difference（ P 〈0.05）. Lysholm scores of the knee joint of patients in two groups after operation were obviously improved, while Lysholm scores in group A at 3 and 12 months were better than those in group B, and there was significant difference（ P 〈0.05）. [Conclusion] Compared with open surgery, arthroscopic surgery for the treatment of PVS has advantages such as minimal invasion, less bleeding and well recovery of knee joint function, so it has high value of clinical application.