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[目的]观察局麻下关节镜手术治疗膝关节滑膜软骨瘤的疗效。[方法]对2010年8月~2015年2月共67例膝关节滑膜软骨瘤的患者在关节镜监视行清除手术,其中男41例,女26例;平均年龄45.2岁(26~67岁);右膝36例,左膝31例;67例患者均在术前明确诊断为膝关节滑膜软骨瘤病;术前主要临床表现为膝关节疼痛、肿胀、关节绞锁等症状。术后立即拍摄X线片,术后4、8和24周,及之后的每6个月均在门诊进行复查随访,末次随访时,对患者进行活动度的测量,以及疼痛视觉模拟评分(VAS)、Lysholm评分和国际膝关节评分委员会IKDC 2000评分。[结果]所有患者术后切口均I期愈合,无相关并发症。67例患者均获得随访,随访时间29.6个月(22~47个月)。末次随访时,术前术后比较,VAS评分由(5.13±1.42)分提高到(1.26±0.54)分(t=5.761,P=0.021),活动度由(68.83±9.23)°提高到(96.62±8.71)°(t=10.283,P=0.008),Lysholm评分由(50.22±6.23)分提高到(78.19±7.15)分(t=-12.372,P<0.001),IKDC 2000评分由(61.36±6.14)分提高到中期(80.07±5.32)分(t=-15.172,P<0.001)。[结论]关节镜下治疗膝关节滑膜软骨瘤创伤小、清理彻底、术后恢复快、中期随访效果确切。
[Objective] To observe the effect of arthroscopic surgery on synovial chondroma in knee joint under local anesthesia. [Methods] A total of 67 patients with synovial chondroma of the knee from August 2010 to February 2015 underwent arthroscopic surveillance. There were 41 males and 26 females, with an average age of 45.2 years (26-67 years ); 36 cases of right knee, 31 cases of left knee; 67 cases were diagnosed as knee synovial chondromatosis preoperatively. The main clinical manifestations were knee pain, swelling and joint twisting. X-rays were taken immediately after surgery and were reviewed at the outpatient setting at 4, 8, and 24 weeks after surgery, and every 6 months thereafter. At the final follow-up, patients were measured for activity and visual analogue scale (VAS ), Lysholm score, and International Knee Scoring Council IKDC 2000 score. [Results] All the incisions were healed one month after operation, with no complications. All 67 patients were followed up for 29.6 months (range, 22-47 months). During the last follow-up, the VAS score increased from (5.13 ± 1.42) points to (1.26 ± 0.54) points (t = 5.761, P = 0.021) and the activity increased from (68.83 ± 9.23) ° to (96.62 Lysholm score increased from (50.22 ± 6.23) points to (78.19 ± 7.15) points (t = -12.372, P <0.001), and IKDC 2000 score increased from (61.36 ± 6.14) to ) Points increased to the mid-term (80.07 ± 5.32) points (t = -15.172, P <0.001). [Conclusion] Arthroscopic treatment of knee joint synovial chondroma is less traumatic, thorough cleaning and quick recovery after operation. The mid-term follow-up effect is exact.