关节镜治疗腘窝囊肿：临床和磁共振成像结果。

Arthroscopic treatment of popliteal cysts: clinical and magnetic resonance imaging results.

机构信息

Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.

出版信息

Arthroscopy. 2010 Oct;26(10):1340-7. doi: 10.1016/j.arthro.2010.02.012. Epub 2010 Sep 24.

DOI:10.1016/j.arthro.2010.02.012

PMID:20869836

Abstract

PURPOSE

This study examined the functional and magnetic resonance imaging (MRI) outcomes of popliteal cysts with combined intra-articular pathologies that were treated arthroscopically by decompression and a cystectomy through an additional posteromedial cystic portal.

METHODS

From January 2003 to March 2008, 31 patients were treated with a modified arthroscopic technique to decompress a popliteal cyst. The connecting valvular mechanism was found in all cases at the posteromedial compartment through the anterolateral viewing portal, and it was corrected by resecting the capsular fold through the posteromedial working portal. For cysts with multiple fibrous septa, an additional portal, the so-called posteromedial cystic portal, was used for complete cyst removal. The functional outcome was evaluated by use of the Rauschning and Lindgren knee score. All patients were evaluated by MRI, which documented the popliteal cyst and associated intra-articular lesions preoperatively and at follow-up.

RESULTS

All patients could return to their previous daily activities with few or no limitations, and no additional surgery was required after a mean follow-up of 36.1 months (range, 12 to 72 months). The Rauschning and Lindgren knee score showed improved clinical features at the final follow-up in 94% of patients. The follow-up MRI study showed that the cyst had disappeared in 17 knees (55%) and had reduced in size in 14 knees (45%) in the 31 patients. The mean cyst size was reduced significantly from 6.8 to 0.8 cm (P < .0001).

CONCLUSIONS

The described arthroscopic technique with or without an additional posteromedial cystic portal is effective for treating popliteal cysts with combined intra-articular lesions. More importantly, follow-up MRI showed that the cyst size was reduced or it had disappeared in all cases, although there was no association between the cyst's disappearance and the follow-up clinical score.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

本研究通过关节镜下减压和囊切除术，检查合并关节内病变的腘窝囊肿的功能和磁共振成像（MRI）结果，该手术通过额外的后内侧囊腔入路进行。

方法

2003 年 1 月至 2008 年 3 月，31 例患者采用改良关节镜技术治疗腘窝囊肿。通过前外侧观察入路在所有病例的后内侧隔室发现连接瓣膜机制，并通过后内侧工作入路切除囊膜皱襞来纠正。对于有多个纤维隔的囊肿，使用另一个称为后内侧囊腔入路的入路来完全切除囊肿。使用 Rauschning 和 Lindgren 膝关节评分评估功能结果。所有患者均接受 MRI 评估，术前和随访时均记录腘窝囊肿和相关关节内病变。

结果

所有患者均能恢复到以前的日常活动，且无明显限制，平均随访 36.1 个月（12 至 72 个月）后无需进一步手术。94%的患者在最终随访时 Rauschning 和 Lindgren 膝关节评分显示出临床特征的改善。31 例患者中有 17 例（55%）的囊肿消失，14 例（45%）的囊肿缩小。囊肿大小从 6.8 厘米显著减少到 0.8 厘米（P <.0001）。