关节镜治疗创伤性髌前滑囊炎36例临床分析

Clinical analysis of arthroscopic treatment in traumatic prepatellar bursitis of 36 cases

目的探讨关节镜下破坏囊壁治疗创伤性髌前滑囊炎的临床疗效。方法回顾性分析2012年2月至2016年4月在本院行关节镜下治疗髌前滑囊炎的36例患者的临床资料。统计手术时间、出血量、住院时间等手术相关指标;比较术前术后VAS评分及膝关节屈伸活动度(ROM)评分情况。结果患者手术时间30~60 min,平均(40±10)min;出血量20~40 mL,平均(30±10)mL。术后住院时间3~7 d,平均(5±2)d。36例患者均在术后1、3、6个月得到随访。患者膝关节肿痛症状术后均得到明显缓解,多在术后4周恢复正常。术前与术后1、3、6个月膝关节疼痛评分(VAS)、膝关节屈伸活动度(ROM)比较差异有统计学意义(P<0.05)。术后3个月与术后6个月VAS评分比较差异无统计学意义。无切口感染发生,1例在引流管口发生部分皮缘坏死,规律换药2周后坏死皮缘痂皮脱落愈合。患者均无局部皮肤麻木、痛性瘢痕形成,术后3个月均可跪地劳动或参加体育锻炼无不适。结论关节镜下失活囊壁治疗创伤性髌前滑囊炎,切口美观,功能效果良好,可作为传统术式的补充方法。

Objective To explore the clinical effect of arthroscopic treatment in traumatic patellar bursitis by inactivating cyst wall.Methods 36 patients with traumatic patellar bursitis were analyzed retrospectively from February 2012 to April 2016.The operation time,bleeding volume and hospitalization time were analyzed,and VAS score and ROM score were compared.Results The operation time was 30-60 min,the average was(40±10)min,the bleeding volume was 20-40 mL,the average was(30±10)mL.The hospitalization time was 3-7 days,with an average of(5±2)days.All 36 patients were followed up in 1 month,3 months and 6 months after operation.Swelling and pain of knee joint were relieved obviously after operation,and disappeared at 4 weeks after operation.The difference of pain score(VAS),knee flexion and extension activity(ROM)between the preoperative and postoperative was statistically significant(P<0.05).No significant difference between VAS score were discovered in 3 months after operation and 6 months after operation.No incision infection occurred,and one case had partial skin edge necrosis at skin near drainage tube.After 2 weeks of regular incision nursery,the scab of the necrosis skin edge was removed and healed.No local skin numbness or painful scar were found,kneel to work or participation in physical exercise were permitted.Conclusion The arthroscopic treatment can be used as a supplement to the traditional operation.