关节镜下“H”形松解术治疗严重膝关节粘连

The Treatment of Serious Knee Arthrofibrosis with "H" shape Lysis Under Arthroscope

目的 探索在关节镜下对严重膝关节粘连的治疗方法及手术适应证。方法 自1999年6月～2001年12月,对32例严重膝关节粘连的患者在关节镜下行“H”形松解术,彻底清除关节内纤维粘连条索,术中辅以轻手法松解,使膝关节达到满意活动度,术毕腔内注射关节粘连预防剂(透明质酸钠)。结果 本组32例患者术后平均随访19个月(8～29个月),膝关节平均活动度113°(90°～130°),较术前平均增加106°(98°～130°)。结论 关节镜下“H”形松解术治疗严重膝关节粘连是一种创伤小、痛苦少、松解彻底、疗效确切、并发症少、操作安全、方便实用的治疗方法。适用于以膝关节内粘连为主的患者,对合并有股四头肌粘连者应辅以其它松解成形术。

Objective To explore the ways of treating serious knee arthrofibrosis under arthroscope and operative indication. Methods From 1996.6 to 2001.12, the 'H' shape lysis was performed for treatment of 12 patient with serious knee arthrofibrosis to thoroughly eliminate adhesion-fibrous chain via knee joint. During the operation, we also used gentle close lysis to make knee joing attain satisfied arthrofibrosis preventive medicine (Sodium hyaluronate) was injected postoperatively into the caritas articularis. Results The 32 cases in this group after operation were interviewed in an average of 19 months (8 to 29 months) . The average active degree was 113° (90°-130°), which compared with that before operation, increased averagely 106° (98° - 130°). Conclusion Treating serious knee arthrofibrosis with 'H' shape lysis under arthroscope is a safe and an effective and very practical new method, mainly applicable to the patients with knee arthrofibrosis, but to those with adhesion of musculus quadriceps femoris other arthroplasty should be assisted.