亚甲蓝染色标记后关节镜下治疗腘窝囊肿的疗效分析

Analysis of therapeutic effect of arthroscopic treatment in treating popliteal cysts after methylene blue staining

目的 探讨使用亚甲蓝染色标记后关节镜手术治疗腘窝囊肿的临床疗效。方法 对2018年5月-2021年11月本院收治的接受亚甲蓝染色后关节镜切除的27例有症状的腘窝囊肿患者病历资料进行回顾性分析。通过VAS(疼痛视觉模拟评分)和Lysholm膝关节评分、Rauschning和Lindgren腘窝囊肿分级评估患者临床疗效,比较患者术前和术后12个月的膝关节功能和疼痛程度。结果 所有27例(男12例,女15例)患者均获得随访,平均术后随访时间(17.2±2.68)个月,平均年龄(60.8±8.23)岁,平均手术时间(28.9±4.67)min。所有病例均发现并治疗了相关的关节内病变,半月板损伤(20例,74.1%)是最常见的病变。术后12个月随访,VAS评分由术前(4.6±0.88)分降低至(0.4±0.58)分(P<0.05),Lysholm评分由术前(48.9±4.94)分提高至(92.1±3.08)分(P<0.05)。Rauschning和Lindgren腘窝囊肿分级,术后12个月(25例0级,2例I级)较术前(2例Ⅰ级,17例Ⅱ级和8例Ⅲ级)明显改善(P<0.05)。没有患者出现关节感染、血肿、神经血管损伤等并发症,末次随访也没有囊肿复发。结论 术前向囊腔注射亚甲蓝可快速定位囊肿范围,关节镜下更完整地切除囊壁,术后患者疗效明确,膝关节功能评分显著改善,复发率低,是值得临床推广的技术。

Objective To explore the clinical efficacy of arthroscopic surgery in treating popliteal cysts after methylene blue staining.Methods A retrospective analysis was performed on the medical records of 27 patients with symptomatic popliteal cysts who underwent arthroscopic resection following methylene blue staining from May 2018 to November 2021.The clinical outcomes were evaluated using the Visual Analogue Scale(VAS)for pain,Lysholm knee score,and Rauschning and Lindgren popliteal cyst grading.Preoperative and 12-month postoperative knee function and pain levels were compared.Results All 27 patients(12 males,15 females)were followed up with an average postoperative follow-up time of 17.2±2.68 months,an average age of 60.8±8.23 years,and an average surgery time of 28.9±4.67 minutes.All cases identified and treated associated intra-articular lesions,with meniscal injuries(20 cases,74.1%)being the most common.At the 12-month follow-up,the VAS score decreased from 4.6±0.88 preoperatively to 0.4±0.58 postoperatively(P<0.05),and the Lysholm score increased from 48.9±4.94 preoperatively to 92.1±3.08 postoperatively(P<0.05).According to the Rauschning and Lindgren popliteal cyst grading,there was a significant improvement at 12 months postoperatively(25 cases at grade 0,2 cases at gradeⅠ)compared to preoperatively(2 cases at gradeⅠ,17 cases at gradeⅡ,and 8 cases at gradeⅢ)(P<0.05).No patient experienced complications such as joint infection,hematoma,or neurovascular injury,and no cyst recurrence was observed at the final follow-up.Conclusions Preoperative injection of methylene blue into the cyst cavity can rapidly delineate the cyst's extent,enabling more complete excision of the cyst wall under arthroscopic visualization.Postoperatively,patients showed clear efficacy,significant improvement in knee joint function scores,and a low recurrence rate,making this a technique worth promoting.