关节镜治疗腘窝囊肿分析

Arthroscopic treatment of popliteal cyst

目的探讨关节镜下治疗腘窝囊肿的方法及临床疗效。方法对48例MRI提示囊肿与后关节囊相通的腘窝囊肿(直径小于5cm)患者分成两组,26例采用关节镜下清理与后内侧间室扩大腘窝囊肿与关节腔之间的通道口,22例采用常规开放手术切除并结扎囊肿蒂部。根据Rauschning和Lindgren分级方法和膝关节MRI评定手术疗效。结果关节镜组术后平均住院时间、切口瘢痕大小、下地活动时间及复发率明显优于常规手术组。48例患者术后均获随访,随访时间为15-31个月,平均25个月。常规手术组有4例复发,关节镜组仅1例严重骨关节炎患者术后复发,后予全膝关节置换术后痊愈。Rauschning和Lindgren分级结果术前与术后两组差异无统计学意义(P>0.05)。结论关节镜下治疗腘窝囊肿具有创伤小、恢复快、复发率低的优点。

Objective To discuss the techniques and efficacy of arthroscopic surgery for popliteal cyst.Methods 48 patients with popliteal cyst indicated by MRI exams were divided into two groups. Of 48 patients, 26 underwent arthroscopic debridement and open surgery to widen the distance between popliteal cyst and articular cavity. The rest 22 patients were treated with common open surgery to excise the cyst and ligate the bottom of the cyst. Rauschning and Lindgren criteria and MRI of the knee joint were applied to evaluate the efficacy of operations. Results The arthroscopic group excelled the common operation group in average hospital stay, size of incision scar, time of postoperative action and recurrence rate. All 48 patients were followed up for 15 to 31 months, 25 months on average. There were 4 cases recurred in common operation group. In arthroscopy group, the recurrence of popliteal cyst in 1 case was involved in severe knee osteoarthritis, which was healed after total knee replacement. According to Rauschning and Lindgren criteria, there was no statistical difference between two groups （P〉0.05）. Conclusions The arthroscopic treatment for popliteal cyst has the advantages of small invasion, quick recovery and low recurrent rate.