关节镜下清理治疗髌前滑囊炎疗效分析

Treatment effect of arthroscopic debridement for prepatellar bursitis

目的通过回顾性分析研究探讨关节镜下清理治疗髌前滑囊炎手术技术及疗效分析。方法于2016年7月—2019年7月郑州市骨科医院运动医学科手术治疗的14名髌前滑囊炎患者,所有患者血液检查指标正常,无一例感染患者,术中于滑囊的两侧建立观察通道和工作通道,插入关节镜和刨刀,彻底清理囊液及滑囊组织,按顺序逐一清理囊壁,两通道交互使用避免留有死角,彻底清理囊壁组织,术中不使用射频处理创面,术毕不放置引流,局部全层缝合加压配合棉腿患肢加压包扎,拄双拐患肢支具伸直位固定2周,2周后去掉支具开始伸屈锻炼,练后继续支具固定,术后4周去拐去支具逐步正常行走。结果术后均无复发,无皮肤损伤、感染、血管、神经损伤并发症,末次随访,疼痛视觉模拟评分(VAS)术前(5.86±0.95)增加至术后(0.43±0.65),患者膝关节活动度由术前(111.21±5.74)恢复至(133.57±2.71),Lysholm膝关节功能评分(58.29±4.23)提高至(86.29±6.99)分,手术前后差异均具有统计学意义(P<0.001)。结论关节镜下清理治疗髌前滑囊炎,创伤小、并发症少,复发率低,功能恢复效果满意。

Objective To retrospectively study the surgical technique and efficacy of arthroscopic debridement for prepatellar bursitis.Methods From July 2016 to July 2019, totally 14 patients with prepatellar bursitis were treated in the Sports medicine department of zhengzhou orthopaedic hospital. All the patients had normal blood test indexes, and no patients were infected.During the operation, a passage was established on both sides of the cyst, arthroscope and shaver were inserted to thoroughly remove the contents.No radiofrequency treatment was used during the operation, no drainage was placed after the operation, local full-layer suture was performed, and the affected limb was dressed up with compression bandage and fixed in a straight position for 2 weeks. followed by flexion exercise with crutches after 2 weeks,4 weeks after surgery to turn to support normal walking.Results No postoperative recurrence, no complications,such as skin damage、infection、neuro-vascular injuries occurred. the VAS score increased from(5.86±0.95) preoperatively to(0.43±0.65) at final follow-up(P<0.001), the range of motion of the knee was improved from(111.21±5.74) preoperatively to(133.57±2.71) at final follow-up(P<0.001),and the Lysholm score increased from(58.29±4.23) to(86.29±6.99)(P<0.001).Conclusion the treatment of prepatellar bursitis with arthroscopic debridement has less trauma, fewer complications, low recurrence rate and satisfactory functional recovery.