关节镜下双后内侧入路单向活瓣切除治疗腘窝囊肿的临床疗效

Clinical effect of arthroscopic double posteromedial approach of one-way valve resection for popliteal cyst

目的探讨关节镜下双后内侧入路单向活瓣切除技术在腘窝囊肿治疗中的应用及临床效果。方法回顾性收集2020年1月至2022年3月于新乡医学院第一附属医院行关节镜下双后内侧入路单向活瓣切除技术治疗的24例腘窝囊肿患者的临床资料,使用疼痛视觉模拟评分法(VAS)、Lysholm膝关节评分、Rauschning和Lindgren腘窝囊肿分级对术前、术后1周、术后6个月膝关节的疼痛程度、关节功能及术后复发率进行评估,并对临床效果进行分级评定。结果术后6个月随访,VAS评分术后低于术前[(1.75±0.85)分vs(5.42±1.31)分,P<0.05];Lysholm膝关节评分术后高于术前[(86.92±7.51)分vs(53.33±9.37)分,P<0.05];Rauschning和Lindgren腘窝囊肿分级,术后6个月(0级17例,Ⅰ级4例,Ⅱ级2例,Ⅲ级1例)明显优于术前(Ⅱ级19例,Ⅲ级5例),差异有统计学意义(Z=3.724,P<0.01)。所有患者术后均未出现关节感染、关节内血肿形成、下肢深静脉血栓形成或神经血管损伤等并发症及腘窝囊肿复发。结论关节镜下双后内侧入路单向活瓣切除技术治疗腘窝囊肿,临床疗效好,复发率低,术后膝关节功能评分提升显著。

Objective To explore the application and clinical effect of double posteromedial approach of one-way valve resection under arthroscopy in the treatment of popliteal cysts.Methods A retrospective study was performed on the clinical data of 24 patients with popliteal cysts undergoing arthroscopic double posteromedial approach of one-way valve resection at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to March 2022.The visual analog scale(VAS),Lysholm score of knee joint and Rauschning-Lindgren grade for popliteal cysts were used to assess the pain degree and joint function before surgery,1 week after surgery and 6 months after surgery.The postoperative recurrence rate and clinical outcomes were observed.Results After 6-month postoperative follow-up,VAS score were significantly lower than that before operation(1.75±0.85 vs 5.42±1.31,P<0.05).Lysholm knee score were higher than that before operation(86.92±7.51 vs 53.33±9.37,P<0.05).Rauschning-Lindgren grade at 6 months after surgery(grade 0 in 17 cases,gradeⅠin 4 cases,gradeⅡin 2 cases,and gradeⅢin 1 case)was significantly better than that before surgery(gradeⅡin 19 cases and gradeⅢin 5 cases)(Z=3.724,P<0.01).All patients had no postoperative complications such as joint infection,intra-articular hematoma,lower limb deep vein thrombosis or neurovascular injury and recurrence of popliteal cysts.Conclusion In the treatment of popliteal cysts,arthroscopic double posteromedial approach of one-way value resection has a good clinical effect,low recurrence rate and significant improvement in postoperative knee joint function.