关节镜下退行性股骨髁间窝前交叉韧带撞击症的诊断和治疗

Arthroscopic diagnosis and treatment of degenerative femoral intercondylar notch impingement syndrome

目的探讨关节镜对退行性股骨髁间窝前交叉韧带撞击症的诊断和治疗。方法对2006年4月～2010年4月期间，在本组应用关节镜检查、治疗存在半月板损伤或关节游离体等症状的膝退行性关节炎129例140膝患者进行回顾性分析，发现合并股骨髁问窝前交叉韧带撞击症有69例72膝，并发率高达51．43％。关节镜下屈伸膝关节动态观察股骨髁间窝与前交叉韧带有无撞击，作出诊断后，行股骨髁间窝扩大成形及关节清理术。结果本组病例随访12～48个月，平均24个月，术后膝前区疼痛、关节积液、关节屈伸功能明显改善，Lysholm评分明显提高。结论膝退行性关节炎并发股骨髁间窝前交叉韧带撞击症，并发率较高，术前较难以明确诊断，关节镜是检查诊断股骨髁间窝前交叉韧带撞击症的金标准，可以明确诊断有无股骨髁间窝前交叉韧带撞击存在及其病因，股骨髁间窝扩大成形后疗效较好。

Objective To evaluate the diagnosis and treatment of the degenerative femoral intercondylar notch impingement syndrome by arthroscopy. Methods From April 2006 to April 2010, 140 knees suffered from osteoarthritis were treated by arthroscope, among which 72 knees were diagnosed as the femoral intercondylar notch impingement syndrome. The incidence was 51.43%. The causes of the anterior cruciate ligament impingement syndrome were indentified by arthroscopy. All the patients underwent arthroscopic intercondylar notchplasty and joint debridement. Results All of the cases were followed for an average time of 24 months （12 - 48 months）. In all the patients, the joint functions were good, especially the knee extention and flexion. The joint pain and the joint effusion were also improved. The Lysholm score increased significantly. Conclusions Arthroscopy is a golden standard for the diagnosis of the degenerative femoral intercondylar notch impingement syndrome; it can make a confirmed diagnosis and treat the femoral intercondylar notch impingement syndrome directly and effectively.