关节镜下关节内减压术治疗半月板周围型囊肿

Treatment of parameniscal cyst with arthroscopic intra-articular decompression

目的 探讨关节镜下联合囊肿关节内减压术及半月板部分切除或缝合治疗半月板周围型囊肿（parameniscal cysts，PC）的疗效。 方法 2009年1月～2011年12月，对22例PC患者采用关节镜下联合囊肿关节内减压术及半月板部分切除或缝合治疗。男性14例，女性8例；年龄22～51岁，平均32.7岁；左膝12例，右膝10例。18例有明确外伤史，其余患者均无明显诱因。病程3～12个月，平均5.2个月。术前Lysholm评分为（60.03 ± 4.89）分，国际膝关节文献委员会分为（64.25 ± 4.22）分。关节镜下见其中外侧半月板18例，内侧半月板4例，按具体部位分前角7例，体部14例，后角1例；所有囊肿均为单发，其中5例为多房。 结果 术后切口均Ⅰ期愈合，无伤口感染、神经、血管损伤等早期并发症发生。术后22例均获随访，随访时间12～24个月，平均 14.5个月。患者术前症状消失或明显减轻，关节活动度恢复正常。术后12个月Lysholm评分为（87.20 ± 4.65）分，IKDC评分为（90.86 ± 3.58）分，与术前比较差异均有统计学意义（P〈 0.05）。采用Glasgow评定标准进行疗效评定，获优16例，良5 例，中1例，优良率达95.45%。随访期间囊肿均无复发。 结论 膝关节镜下联合囊肿关节内减压术及半月板部分切除或缝合治疗PC创伤小、康复快，可获得确切的临床疗效。

Objective：To investigate the results of arthroscopic treatment of parameniscal cyst（PC） with intra-articular decompression of cyst and meniscectomy or suture. Methods：From January 2009 to December 2011,22 cases of parameniscal cyst were treated by arthroscopy with intra-articular decompression of cysts and meniscectomy or suture, including 14 males and 8 females, with an average age of 32.7 years（ranging from 22 to 51 years）. Twelve patients suffered in left knees, 10 in right ones. Eighteen cases had trauma history and the others had no obvious predisposing causes. The average disease duration was 5.2 months （ranging from 3 to 12 months）. Before the operation,the Lysholm score was 60.03 ± 4.89 and the International Knee Documentation Committee（IKDC） sub- jective evaluation score was 64.25 ± 4.22. Four patients had medial parameniseal cyst and t8 patients had lateral parameniseal cyst. There were 7 cysts in meniscal anterior horn, 14 cysts in meniscal body and 1 cyst in meniscal posterior horn;all being single cyst and 5 being mulfilocular cyst. Results：All incisions healed by the first intention without complication. All patients were followed up for 12 to 24 months with an average of 14.5 months. Preoperative symptoms disappeared or reduced and the range of motion of the knee returned to normal. The Lysholm knee score and IKDC subjective evaluation score were significantly increased to 87.20 ± 4.65 and 90.86 ± 3.58 at 1 year after the operation（P〈0.05）. According to assessment standard described by Glasgow,the treatment out- come was excellent in 16 cases,good in 5 cases and general in 1 case;the excellent and good rate was 95.45%. No recurrence was found during the follow-up. Conclusion：Arthroscopic management of paramenical cyst with intra-articular decompression of cyst and meniscectomy or suture results in a good clinical outcome with minor invasion and rapid recovery.