Sarpel Yaman, Ozkan Cenk, Toğrul Emre, Tan Ismet, Gülşen Mahir
Department of Orthopaedics and Traumatology, Cukurova University Faculty of Medicine, Balcali, 01330, Adana, Turkey.
Arch Orthop Trauma Surg. 2007 May;127(4):229-34. doi: 10.1007/s00402-006-0138-1. Epub 2006 Jul 8.
Arthroscopic operations performed in the pediatric age group constitute less than 5% of all arthroscopies. Diagnostic accuracy is reported to be lower than the procedures in adult patients. The incidence of pathologies also varies in the literature. We aimed at assessing the diagnostic accuracy of arthroscopy and review the incidence of pathologies in pre-adolescent patients.
In the period April 1990-January 2002, 50 pre-adolescent patients underwent knee arthroscopy after clinical and radiological assessment. Average age was 10.24 (1-13) with a male-to-female ratio of 34:16.
Discoid lateral meniscus was found to be the most common pathology encountered in 17 cases followed by infection and synovitis in 8 cases each. Diagnostic accuracy of arthroscopy correlated with preoperative clinical and radiologic evaluation was 90%. Arthroscopy findings were negative in two cases. Two cases of plica syndrome and one case of chondral injury were mistaken for medial meniscal tear. Final diagnosis was familial Mediterranean fever in one case of synovitis and knee fusion was performed at follow-up due to progressive degenerative changes. No other patient required reoperation.
Arthroscopy is a safe procedure with minor morbidity allowing treatment of various intraarticular knee disorders. Diagnostic accuracy of the procedure may increase with careful preoperative work-up.
儿科患者接受的关节镜手术占所有关节镜手术的比例不到5%。据报道，其诊断准确性低于成年患者的手术。文献中病理情况的发生率也有所不同。我们旨在评估关节镜检查的诊断准确性，并回顾青春期前患者的病理发生率。
在1990年4月至2002年1月期间，50例青春期前患者在经过临床和放射学评估后接受了膝关节镜检查。平均年龄为10.24岁（1 - 13岁），男女比例为34:16。
发现盘状外侧半月板是最常见的病理情况，共17例，其次是感染和滑膜炎，各8例。关节镜检查与术前临床和放射学评估相关的诊断准确性为90%。有2例关节镜检查结果为阴性。2例滑膜皱襞综合征和1例软骨损伤被误诊为内侧半月板撕裂。1例滑膜炎最终诊断为家族性地中海热，随访时因进行性退变改变而进行了膝关节融合术。没有其他患者需要再次手术。
关节镜检查是一种安全的手术，发病率较低，可用于治疗各种膝关节内疾病。通过仔细的术前检查，该手术的诊断准确性可能会提高。
