关节镜下治疗膝关节内侧滑膜皱襞综合征

Arthroscopic Treatment of Media Plica Syndrome of the Knee

目的探讨膝关节内侧滑膜皱襞综合征的临床诊断、治疗方法及结果。方法自2006年10月至2010年11月期间,我院共诊治膝关节内侧滑膜皱襞综合征患者87例,其中46例采取保守治疗后症状无缓解而接受关节镜下手术切除滑膜皱襞。男24例,女22例;年龄23～72岁,平均年龄为41岁。按Sakakibara法对滑膜皱襞进行分类,在关节镜下行皱襞切除术,并随访记录其疗效。结果 46例经关节镜下皱襞切除的患者,其中A型27例,B型15例,C型3例,D型1例;同时合并9例半月板损伤,5例髌股关节内侧面骨关节炎形成。增生的滑膜皱襞均采用篮钳或刨削器将其切除。43例获得随访,平均随访时间为25个月,无复发病例。膝关节功能根据Lysholm评分进行评定,术后功能较术前明显改善,治疗结果优良率为90.7%。结论膝关节内侧滑膜皱襞综合征根据临床症状和MRI表现即可诊断,关节镜下可以确诊,同时镜下行滑膜皱襞切除可获得满意的效果。

Objective To evaluate the clinical diagnosis and the arthroscopic treatment results of and medial plica syndrome.Methods From October 2006 to November 2010,there were 87 patients diagnosed media plica syndrome of the knee,46 of them were treated by arthroscopic resection.Results According to the Sakakibara classification,there were 27 cases of Type A,15 cases of Type B,3 cases of Type C,1 case of Type D.There were 9 cases with meniscus lesion and 5 cases of femoral-patellar osteoarthritis.43 cases were followed up.The mean follow-up period was 25months.The knee function was evaluated with Lysholm score,the results of 39 cases were graded as excellent or good.Conclusions The diagnosis of media plica syndrome can be made by clinical symptom and MRI,and arthroscopy can confirm the diagnosis.The results treated by arthroscopy were satisfactory.