关节镜下内减压术治疗膝关节半月板囊肿

Arthroscopic decompression of knee meniscal cysts

目的探讨膝关节镜下半月板切除或缝合及囊肿内减压术治疗半月板囊肿的疗效。方法回顾性分析2005年12月～2010年7月采用膝关节镜治疗的23例外侧半月板囊肿患者。术中行半月板部分或全部切除及缝合处理半月板撕裂,使用射频及刨削刀扩大囊肿内口使其与关节腔相通,清理囊肿内容物及分隔。术后指导患者行患肢功能锻炼,门诊随访。术前术后进行膝关节Lysholm功能评分对比。结果所有患者均可见半月板不同程度撕裂。全部病例获随访,平均随访时间20.2个月。术后膝关节疼痛症状消失或明显缓解,关节交锁和弹响症状消失,随访期内无囊肿复发病例。膝关节Lysholm评分术前为(59.3±12.2)分,术后为(81.±410.4)分,差异有显著性(t=-10.342,P=0.002)。结论膝关节镜下半月板切除或缝合加内减压术治疗半月板囊创伤小、康复快,可获得确切的临床疗效。

[ Objective ] To investigate the resuh of arthroscopic treatment of meniscal cysts using inner wall decompression and meniscectomy or repair. [Methods] Included in this retrospective study were 23 cases with lateral meniscal cysts treated arthroscopicly between Dec 2005 and Jul 2010, among which were 13 males and 10 females with an average age of 33.9 years. Meniscal tears were treated either with meniscectomy （partial or total） or repair. The inner wall of the cysts were detected and decompressed to extend their communication to the articular cavity. Contents and septa inside the cysts were meanwhile debrided. Functional excise and rehabilitation were performed postoperatively. All patients were followed-up and the pre- and postoperative Lysholm knee function scores were evaluated and compared. [ Results ] All patients were detected under arthroscopy with various degrees of meniscal tears. Out-patient follow-up were achieved with an average period of 20.2 months. As a result, the knee pain was fully or mostly relieved, and symptom of locking and clicking were vanished after operation. No recurrence of meniscal cyst during the follow-up period. The average Lysholm knee score was improved from preoperative （59.3 ± 12.2） to postoperative （81.4±10.4）. The difference was statistically significant （t=-10.342, P =0.002）. [Conclusion] Arthroscopic management of menical cysts by inner wall decompression and meniscectomy or repair results in a good clinical outcome with minor invasion and rapid recovery.