射频汽化仪用于膝关节镜手术的临床初探

Preliminary study on usage of ArthroCare radiofrequency in knee arthroscopic surgery

目的探索冷融化技术在膝关节镜手术中的应用前景和手术技术。方法采用 ArthroCare 2000汽化仪对 20例不同膝关节疾病患者施行关节镜手术。关节镜下诊断疾病分别为：半月板撕裂 6例，股骨髁关节软骨退变 6例，髌骨半脱位 5例，滑膜增生性炎症 2例，前十字韧带部分损伤 1例。通过汽化仪做膝关节镜下半月板部分切除、损伤软骨面及韧带修整、滑膜部分切除以及髌骨外侧支持带松解术等。结果术后膝关节无须加压包扎，分别于术后 24、 48及 72 h对术侧膝关节做浮髌试验检查，均为阴性。术后 24 h行 CPM锻炼，均无明显膝关节疼痛。患者自觉症状良好。镜下观察关节和半月板软骨处理面光整，无出血。结论 ArthroCare 2000汽化仪操作方便，治疗精确，在切除病损组织时最大限度地减少了邻近组织损伤，同时具有止血功能，有利于早期康复。

Objective To explore the surgical technique and its promising future of coblation in knee arthroscopic surgery. Methods Twenty cases of different knee problems were treated arthroscopically for partial meniscectomy, cartilage or ligament trimming, synovictomy or lateral retinaculum release with usage of ArthroCare 2000 radiofrequency machine. Arthroscopic diagnosis for these 20 cases were as follows, meniscus tear 6 cases, degenerative cartilage injury on femoral condyle 6 cases, patellar subluxation 5 cases, inflammatory synovitis 2 cases and partial injury of anterior cruciate ligament 1 case. Results The clinic results showed that treatment of injured tissue handled by coblation technique was much precise than that handled by the conventional technique, the former was featured by relative less invasive to the near normal areas and spontaneous coagulation function. No compression wraps were needed to be applied during operation. All patients were comfortable postoperatively with their pain- free and no swelling knees. Conclusion Less pain and easy for early rehabilitation for all ArthroCare 2000 treated cases imply that coblation technique could greatly enhance the clinic results of arthroscopic surgery for knee diseases.