重度骨性关节炎合并腘窝囊肿患者行膝关节置换术中腘窝囊肿处理对功能锻炼及术后并发症的影响

Effect of popliteal cyst treatment on functional exercise and postoperative complications in patients with severe osteoarthritis and popliteal cyst total knee arthroplasty

目的探讨重度骨性关节炎合并腘窝囊肿患者行膝关节置换术中腘窝囊肿处置对功能锻炼和术后并发症的影响。方法选取2017年6月至2020年6月单县中心医院收治的42例重度膝关节骨性关节炎合并腘窝囊肿行全膝关节置换患者作为研究对象,采用随机数字表法分为研究组与对照组,每组21例。研究组行膝关节置换术前在彩超引导下穿刺治疗腘窝囊肿,对照组行膝关节置换术,去除腘窝囊肿的形成的病变基础。所有患者均获得随访,随访时间均>24个月。比较两组腘窝囊肿变化、膝关节特种外科医院膝关节评分(hospital for special surgery knee score,HSS)、疼痛缓解、术后并发症发生情况。结果两组术后末次随访疼痛、关节功能、活动度、稳定性、屈曲畸形、下肢肌力评分及总分比较差异无统计学意义;两组优良率比较差异无统计学意义;两组术后腘窝囊肿变化比较差异无统计学意义;两组术后并发症发生情况比较差异无统计学意义。结论重度骨性关节炎合并腘窝囊肿患者行人工膝关节置换术术前无需对腘窝囊肿进行特殊处置,单纯切除基础病变,术后腘窝囊肿消失或明显减小并不影响关节功能锻炼,且未增加术后并发症发生率。

Objective To investigate the effect of popliteal cyst treatment on functional exercise and postoperative complications in patients with severe osteoarthritis and popliteal cyst total knee arthroplasty.Methods 42 patients with severe knee osteoarthritis complicated with popliteal cyst undergoing total knee arthroplasty from June 2017 to June 2020 in Central Hospital of Shanxian were selected as the research subjects,and they were randomly divided into the study group and the control group,with 21 cases in each group.The study group received ultrasound-guided puncture treat-ment of popliteal cyst before knee arthroplasty,while the control group received knee arthroplasty to remove the pathological basis of popliteal cyst formation.All patients were followed up for more than 24 months.The changes of popliteal cyst,hospital for special surgery knee score(HSS)score,pain relief and postoperative complications were compared between the two groups.Results There were no significant differences in pain,joint function,range of motion,stability,flexion deformity,lower limb muscle strength score and total score between the two groups at the last follow-up;there was no significant difference in the excellent and good rate between the two groups.There was no significant difference in the changes of popli-teal cyst between the two groups;there was no significant difference in postoperative complications between the two groups.Conclusion Patients with severe osteoarthritis complicated with popliteal cyst do not need special treatment of popliteal cyst before artificial knee arthroplasty.Simple re-moval of the pathological basis does not affect joint function exercise and does not increase postoperative complications.