膝关节色素沉着绒毛结节性滑膜炎的手术治疗策略与疗效分析

The surgical strategies and clinical efficacy of the treatment on Pigmented Villonodular Synovitis of the Knee

目的探讨膝关节色素沉着绒毛结节性滑膜炎的手术治疗策略与临床疗效。方法1998年1月-2008年12月，对收治疗的28例膝关节色素沉着绒毛结节性滑膜炎患者根据患膝病变的范围及程度分别实行不同的手术治疗方法，术后给予积极的放疗及康复治疗，分析术后疗效及各种手术治疗方法的特点。结果术后随访2～11年，行膝关节镜下滑膜切除术16例，1例复发，再次行膝关节镜手术治疗。行膝关节切开滑膜切除术7例，1例复发，行全膝关节表面置换术6例，未见复发，末次随访6例患者假体位置良好，无松动。结论膝关节色素沉着绒毛结节性滑膜炎由于关节滑膜受累范围及骨软骨破坏程度不同，治疗的关键在于手术方法的正确选择，结合术后放疗及康复治疗可以减少术后复发率及最大程度恢复和保持膝关节功能。

Objective To study the surgical strategies and clinical efficacy of the treatment on Pigmented Villonodular Synovitis of the knee. Methods January 1998 - December 2008, 28 patients with pigmented villonodular synovitis of the knee were performed with different surgical treatment methods according to the knee scope and extent of the lesions combine with the postoperative positively radiation therapy and rehabilitation. The characteristics of surgical treatment and the postoperative efficacy were analyzed. Results The patients were followed up 2.0 to 11.0 years ; among which, 16 cases underwent Arthroscopic synovectomy, and 1 case recurred during follow-up , who was per- formed knee Arthroscopic synovectomy again. 7 cases underwent open knee joint synovectomy and 1 case recurred. 6 cases were performed total knee replacement; there were no case showed recurrence and the prosthesis of the 6 patients were in good position and no loose cases occurred on the last follow up. Conclusion As the scope of synovium and bone and cartilage destruction involved in varying degrees, the key surgical treatment is to made a correct choice, and combined with postoperative radiotherapy and rehabilitation can reduce the recurrence rate and maximum restore and maintain the knee.