色素绒毛结节性滑膜炎镜下治疗

Arthroscopic Treatment of Pigmented Villonodular Synovitis

目的 对弥漫型色素绒毛结节性滑膜炎镜下治疗进行分析。方法 1986年 10月以来共收治膝关节弥漫型色素绒毛结节性滑膜炎 18例 ,均行镜下滑膜刨削术 ,其中前 8例经三关节镜入路 (前外侧、前内侧、髌上外侧 )行部份滑膜切除 ,后 10例经五关节镜入路 (前外侧、前内侧、髌上外侧、后外侧、后内侧 )行次全滑膜切除 ,经滑膜病理检查明确诊断。结果 18例平均随访 96个月 (最短 2 4个月 ,最长 169个月 )无手术并发症 ,部分滑膜切除病例中有 1例复发 ,再次行关节镜手术有效 ,次全滑膜切除病例未见复发。结论 弥漫型色素绒毛结节滑膜炎镜下次全滑膜切除疗效满意 。

Objective To study the arthroscopic treatment of diffuse pigmented villonodular synovitis (PVNS) of the knee.Methods 18 patients of diffuse PVNS of the knee were treated by arthroscopic synovectomy.Initial 8 patients underwent arthroscopic partial synovectomy using 3 portals (anteromedial,anterolateral,suprapatellar-lateral).The rest (10 patients) underwent arthroscopic extended Synovectomy in 5 portals (anteromedial anterolateral,suprapatellar-lateral,posteromedial,posterolateral).The diagnosis was confirmed by synovial biopsy.Results All of cases were followed-up for an average 96 months (minimrm,24.maximum,169).No relevant complications were encountered.One of cases for arthroscopic surgery.No recurrence patient was in the group treated with arthroscopic partial synovectomy recurred and recovered by the revison of arthroscopic partial synovectomy recurred and recovered by the revision of arthroscopic surgery.No recurrence patient was in the group treated with arthroscopic extended synovectomy.Conclusions The clinical results with arthroscopic extended synovectomy for the diffuse PVNS is excellent.The arthroscopic extended synovectomy in the posterior portion of the knee is more difficulty than another parts.