关节镜与开放式手术治疗膝关节色素沉着绒毛结节性滑膜炎的效果比较

Comparison of the effects of arthroscopy and open surgery in the treatment of pigmented villonodular synovitis of knee joint

目的比较关节镜与开放式手术治疗膝关节色素沉着绒毛结节性滑膜炎(PVNS)的效果。方法将于空军军医大学西京医院行膝关节外科手术治疗的44例PVNS患者根据手术方式分为开放式手术组(21例)和关节镜手术组(23例)。比较两组术前及末次随访时的疼痛程度、膝关节功能、关节活动度及复发情况。结果末次随访时,两组的VAS评分均降低,Lysholm评分及关节活动度均升高,且关节镜手术组的关节活动度大于开放式手术组(P<0.05)。结论关节镜及开放滑膜切除治疗均能减轻膝关节PVNS患者的疼痛,改善关节功能,且术后复发率无显著差异。但关节镜具有创伤小、恢复快及并发症少等优势,可能成为PVNS膝关节外科治疗的首选手术方式。

Objective To compare the effects of arthroscopy and open surgery in the treatment of pigmented villonodular synovitis(PVNS)of knee joint.Methods Forty-four patients with PVNS who underwent knee joint surgery in Xijing hospital,air force military medical university were divided into open surgery group(21 cases)and arthroscopic surgery group(23 cases)according to the surgical methods.The degree of pain,knee joint function,range of motion of joint before surgery and at the last follow-up and recurrence were compared between the two groups.Results At the last follow-up,the VAS score decreased,Lysholm score and range of motion of joint increased in both groups,and the range of motion of joint in the arthroscopic surgery group was greater than that in the open surgery group(P<0.05).Conclusion Both arthroscopy and open synovectomy can reduce pain and improve joint function in patients with PVNS of knee joint,and there is no significant difference in postoperative recurrence rate.However,arthroscopy has the advantages of less trauma,faster recovery and fewer complications etc.,and it may be the preferred surgery method of PVNS knee joint surgery treatment.