关节镜下手术治疗成人腘窝囊肿

Arthroscopic-assisted surgery of adult popliteal cyst

目的：探讨关节镜下治疗腘窝囊肿的方法和疗效。方法2013年6月－2015年12月采用关节镜技术进行手术治疗成人腘窝囊肿患者28例，男11例，女17例，年龄42～69岁，平均51．2岁，27例为单侧腘窝囊肿，1例为双侧腘窝囊肿，处理关节内病变的同时，扩大腘窝囊肿和关节腔之间的通道口，清除腘窝囊肿囊壁，所有操作均在关节镜下完成，使用Raus-chning和Lindgren腘窝囊肿分级方法评估手术疗效。结果术中均发现伴有不同类型关节内病变，以半月板损伤和骨关节炎最常见，术中、术后未出现血管、神经损伤和小腿骨筋膜室综合征，随访6～22个月，所有病例均无腘窝囊肿复发，Rauschning和Lindgren腘窝囊肿分级标准评价结果，术前结果：1级3例，2级9例，3级16例。术后结果：0级25例，1级3例。结论成人腘窝囊肿的治疗，应重视关节内病变、通道口和腘窝囊肿本身这三个方面，关节镜下手术治疗成人腘窝囊肿具有创伤小、复发率低、恢复快、并发症少的优点。

Objective To evaluate the therapy options and effect of arthroscopic-assisted surgery of adult popliteal cyst. Methods From June 2013 to December 2015, 28 patients of adult popliteal cysts were treated under the arthroscopy, including 11 males and 17 females, average age of 51.2 years ranging from 42 to 69 years, including 27 cases unilateral popliteal cyst, 1 cases bilat-eral popliteal cyst. During operation, the intra-articular pathology were corrected, the connecting hole between popliteal cyst and joint space were enlarged and the pcapsule were cleared, and all operations are done under arthroscopy. The postoperative effect was evalua-ted according to criteria of popliteal cyst of Rauschning and Lindgren. Results The different types of intra-articular pathology were found in all patients, of which meniscus injury and osteoarthritis were the most common types. There were no complication of blood ves-sel, nerve and compartment syndrome during and after the surgery. No recurrence of popliteal cyst were found in all patients during the follow-up of 6-22 months. According to the guidelines of Rauschning and Lindgren, there were 3 cases of grade 1, 9 cases of grade 2, and 16 cases of grade 3 before surgery. After surgery, there were 25 cases of grade 0 and 3 cases of grade l. Conclusion The surgery of adult popliteal cyst should take into account intra-articular pathology, the connecting hole and the cyst itself. The arthroscopic-assis-ted surgery of adult popliteal cysts has the advantages of mini-invasion, low complication, fast-recovery and low recurrence rate.