关节镜术诊断与治疗退行性股骨髁间窝前交叉韧带撞击症

Arthroscopic Diagnosis and Treatment of Degenerative Femoral Intercondylar Fossa Impingement Syndrome

目的:报道退行性股骨髁间窝前交叉韧带撞击症14膝.作者对关节镜在本病诊断中的优点、分型及治疗方法进行探讨.方法:所有病人均合并骨性关节炎,男5膝,女9膝;左侧8膝,右侧6膝.主要表现为膝关节前部或定位不确定的钝痛、渐进性关节伸屈障碍和反复关节积液.关节镜术野良好,可动态检查前交叉韧带在运动中所受阻碍的情况,提高本病诊断率并有助于分型,关节镜下可将本病分为三型:磨损型、挤夹型、混合型.治疗采用关节镜下股骨髁间窝扩大成形术加镜下关节清理术.结果:随访13例,平均18个月,术后关节功能均超过术前水平,尤其关节伸屈功能障碍改善明显,目前尚无复发需再次手术者.结论:关节镜术对本病的诊断与治疗益处颇多,关节镜下股骨髁间窝扩大成形术是治疗本病的良好方法.

Objective: Arthroscopy was performed in 14 patients with degenerative femoral intercondylar fossa impingement syndrome. The author probed into the advantages, types and therapy methods of the arthroscopic notchplasty. Methods: All of patients suffered from osteoarthritis of the knee, including male in 5 cases and female in 9 cases, 8 in the left knee and 6 in the right. The main symptoms were pain, restriction and recurrent swelling. Three patterns of distinct arthroscopic appearances were noted: the abrasion, locking and mixture. The diagnosis and treatment were all performed by arthroscopic arthroplasty. Results; Thirteen patients were followed-up for an average of 18 months. Good function was seen in all (especially in extension and flexion) and there was no recurrence. Conclusion; The authors emphasize that arthroscopic notchplasty is helpful for the establishment of the diagnosis and treatment.