关节镜下半月板囊肿切除联合缝合修补治疗外侧半月板多房囊肿的临床效果

Clinical Evaluation of Arthroscopic Resection of Meniscus Cysts Combined with Suture Repair of Meniscus in the Treatment of Multilocular Cysts of Lateral Meniscus

目的:探讨关节镜下半月板囊肿切除联合缝合修补治疗外侧半月板多房囊肿的临床效果。方法:选取2017年1月-2019年12月作者手术治疗的症状性外侧半月板多房囊肿患者53例,其中男性22例、女性31例,左膝30例、右膝23例,年龄30.4±6.3岁。术前磁共振成像(MRI)评估多房囊肿的范围和半月板损伤情况,术中采用前外下入路操作和常规前内侧入路监视下完整清除囊肿,并去除不稳定半月板部分,根据稳定情况决定是否行Outside-in固定,术后立即完全负重快速康复。随访期1年,通过手术前后疼痛视觉模拟评分(visual analogue scale,VAS)和Lysholm膝关节评分评估手术效果,行MRI明确囊肿是否复发。结果:53例患者术后无严重并发症;所有患者临床症状均较术前明显改善;术后1年的VAS评分显著低于术后6月,均较术前明显降低(P<0.05);术后1年的Lysholm膝关节评分显著高于术后6月,均较术前明显提高(P<0.05)。术后1年行MRI未见囊肿复发。结论:关节镜下半月板囊肿切除联合缝合修补,治疗外侧半月板多房囊肿,能够显著改善患者疼痛和关节功能,避免囊肿复发。

Objective To explore the clinical effect of arthroscopic resection of meniscus cysts combined with suture repair of meniscus in the treatment of multilocular cysts of lateral meniscus.Methods Totally 53 patients with symptomatic multilocular cysts of the lateral meniscus and receiving surgery in2017 and 2019 were selected in this study,including 22 males and 31 females aged 30.4±6.3 years,30 left knees and 23 right knees.Preoperative magnetic resonance imaging(MRI)was performed for accurate evaluation of the scope of multilocular cysts and meniscus injury.During the operation,the infra-anterolateral and anteriormedal portal were used to remove the cyst completely and the unstable part of the meniscus.Moreover,the outside-in technique was manipulated according to the stability of residual meniscus.All patients underwent the rapid rehabilitation protocol with full weight bearing immediately after the surgery and were followed up for 1 year.Before and one year after the operation,all patients were evaluated using the visual analogue scale(VAS)and Lysholm knee score.Moreover,MRI was performed to determine whether the cyst recurred.Results After the surgery,no serious complications were found in the 53 patients,and significant improvement was observed in their clinical symptoms.The average VAS score one year after the surgery was significantly lower than six months earlier,and both were significantly lower than before the surgery(P<0.05).However,the average Lysholm knee score 1 year after the surgery was significantly higher than 6 months earlier,and both were significantly higher than before the operation(P<0.05).No recurrence of the cysts was observed on MRI 1 year after the surgery.Conclusion The arthroscopic resection of meniscus cysts combined with suture repair of meniscus can significantly relieve the pain,improve the function of knees and avoid the recurrence among the patients with multilocular cysts of lateral meniscus.