关节镜在急性创伤性膝关节积血诊治中的应用

Application of arthroscopy in diagnosis and treatment of acute traumatic hemarthrosis of the knee joint

目的 评价关节镜在急性创伤性膝关节积血诊治中的应用价值。方法 自 2 0 0 2年 1月～ 2 0 0 3年 1月 ,对 2 6例X线检查无胫骨平台、股骨髁及髌骨骨折的急性创伤性膝关节积血患者施行早期关节镜检查。结果 关节镜检查发现MCL损伤 19例 (73.1% ) ,ACL损伤 16例 (6 1.5 % ) ,半月板损伤 10例(38.5 % ) ,其中复合性损伤 12例 ,占 4 6 .2 %。术前漏诊前交叉韧带损伤 6例 ,半月板损伤 5例。结论 急性膝关节积血预示膝关节内或其周围结构的严重损伤 ,早期关节镜检查有利于明确诊断 ,有助于选择治疗方法及制定相应康复措施。

Objective:To evaluate the value of arthroscopy in diagnosis and treatment of acute traumatic hemarthrosis of the knee.Methods:From January 2002 to January 2003,arthroscopy was performed on 26 patients with acute traumatic hemarthrosis of the knee.The average time between trauma and arthroscopy was 4 days.Hemarthrosis was confirmed by puncture of the joint.The fractures of patella,femoral condyle and tibia plateau were excluded by a conventional X-ray.Results:Arthoscopy demonstrated a ruptured anterior cruciate ligament in 61.5 %,meniscal tears in 38.5 %,disruption of medial collateral ligaments in 73.1 %.Lesions of 12 patients (46.2 %) were combined.The diagnosis of 6 anterior cruciate ligamentum and 5 meniscus injuries were missed.Conclusions:A acute traumatic hemarthrosis indicates a serious knee injury.Arthroscopic evaluation is a valuable tool not only in differential diagnosis but also in making treatment and rehabilitation programs of acute traumatic hemarthrosis of the knee.