关节镜下后内侧双通道入路治疗腘窝囊肿的临床疗效分析

Study on the clinical efficacy of arthroscopic treatment of Baker's cyst via two posteromedial portals

目的 比较关节镜下经后内侧双通道入路与后内侧单通道入路治疗腘窝囊肿的临床疗效。方法 回顾性分析连云港市第一人民医院关节外科2019年1月至2021年1月收治的手术切除的腘窝囊肿患者53例。将患者分为两组:单通道组25例,双通道组28例。单通道组病例采取传统关节镜下单通道入路治疗腘窝囊肿;双通道组病例采取关节镜下双通道入路治疗腘窝囊肿。记录两组患者的手术时间、囊肿最终结局、手术并发症,以及术前、末次随访的Lysholm评分和Rauschning and Lindgren评分。结果 最终纳入53例病例,随访时间11~13个月,平均随访时间为(12.70±0.35)个月。双通道组手术时间长于单通道组,差异具有统计学意义(P<0.05)。单通道组复发率高于双通道组,差异具有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。两组组内术前、末次随访的Lysholm评分比较,差异具有统计学意义(P<0.05);两组间末次随访Lysholm评分比较,差异无统计学意义(P>0.05)。两组组内术前、末次随访的Rauschning and Lindgren评分比较,差异具有统计学意义(P<0.05);末次随访Rauschning and Lindgren评分显示双通道组的功能评价优于单通道组,差异具有统计学意义(P<0.05)。结论 关节镜下经后内侧双通道入路治疗腘窝囊肿较传统单通道入路是一种具有更低复发率,更好的短期疗效,且同样安全的手术方法。

Objective To evaluate the clinical efficacy of arthroscopic treatment of Baker's cyst via two posteromedial portals versus one posteromedial portals.Methods Fifty-three cases of Baker's cyst treated by surgery from January 2019 to January 2021 in the First People's Hospital of Lianyungang were retrospectively analyzed.Patients were divided into two groups,and the final eligible cases were listed below:One posteromedial portals group(25 cases),two posteromedial portals group(28 cases).Recorded and analyzed:①Operation time,magnetic resonance imaging results at the last follow-up(cure/recurrence),postoperative complications;②Preoperative and postoperative Lysholm score,Rauschning and Lindgren score.Results Fifty-three cases were finally included in this experiment,and were followed up for 11 to 13 months,with an average of(12.70±0.35)months.The operation time of the two posteromedial portals group was longer than that of the one posteromedial portals group,the difference was statistically significant(P<0.05).The recurrence rate of one posteromedial portals group was higher than that of two posteromedial portals group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications(P>0.05).There was a statistically significant difference between the preoperative Lysholm score and Rauschning and Lindgren scores of the two groups compared to that of the last follow-up(P<0.05).There were no significant differences in the Lysholm score at the last follow-up between the two groups(P>0.05).According to Rauschning and Lindgren grade,we found that the functional evaluation of the two posteromedial portal group was better than that of the one posteromedial portal group,the difference was statistically significant(P<0.05).Conclusion Arthroscopic treatment of Baker's cysts via two posteromedial portals is a less recurrent,better short-term,and equally safe surgical method than traditional one posteromedial portals.