全关节镜后内入路治疗腘窝囊肿的效果分析

Effect Analysis of posterior treatment approach of total arthroscope on popliteal cyst

目的探讨全关节镜下后内侧入路治疗腘窝囊肿的手术方法及疗效。方法回顾性研究2014年8月至2017年8月,采用后内侧入路全关节镜下腘窝囊肿切除并内侧引流治疗58例,其中男性18例,女性40例。所有患者均行术前磁共振成像(MRI)检查关节内病变以及腘窝囊肿与膝关节腔之间的联系。通过VAS评分和Lysholm评分评估临床疗效。结果术中发现内侧半月板损伤20例、外侧半月板损伤14例、骨关节炎22例、关节内游离体6例、髌股关节软骨损伤10例。术中及术后均无感染及重要血管神经损伤,腘窝囊肿无复发,术后平均随访6-24个月。术后VAS评分明显下降,Lysholm评分较术前显著提高。结论腘窝囊肿并非独立存在,通过后内侧入路进行关节镜下腘窝囊肿治疗,同时处理膝关节内病变,不仅减少了复发率,也提高治疗效果,是一种安全可靠,疗效满意的微创手术治疗方法。

Objective To investigate the surgical method and efficacy of posterior medial approach for popliteal cyst under total arthroscope.Methods From August 2014 to August 2017,58 patients(18 males and 40 females)were treated with posterior medial approach total arthroscopic popliteal cyst resection and medial drainage.All patients underwent preoperative magnetic resonance imaging(MRI)to examine intra-articular lesions and the association between popliteal cyst and the knee cavity.VAS score and Lysholm score were used to evaluate the clinical efficacy.Results 20 cases of medial meniscus injury,14 cases of lateral meniscus injury,22 cases of osteoarthritis,6 cases of intra-articular free body injury,10 cases of patellofemoral articular cartilage injury were found.There was no infection or significant vascular and nerve injury during and after the operation,and there was no recurrence of popliteal cyst.The average follow-up was 6-24 months after the operation.VAS score decreased significantly after surgery,while Lysholm score was significantly higher than that before surgery.Conclusion Popliteal cyst does not exist independently.Arthroscopic treatment of popliteal cyst through posterior medial approach and treatment of intra-knee lesions at the same time not only reduces the recurrence rate but also improves the therapeutic effect.It is a safe,reliable and minimally invasive surgical treatment with satisfactory efficacy.