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关节镜下后交叉韧带腱鞘囊肿切除术采用后隔室经皮入路。

Arthroscopic excision of ganglion cysts of the posterior cruciate ligaments using posterior trans-septal portal.

机构信息

Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Arthroscopy. 2012 Jan;28(1):95-9. doi: 10.1016/j.arthro.2011.07.013. Epub 2011 Oct 20.

DOI:10.1016/j.arthro.2011.07.013
PMID:22019231
Abstract

PURPOSE

To evaluate clinical outcomes of arthroscopic excision of ganglion cysts involving the posterior cruciate ligament (PCL) using the posterior trans-septal portal in the knee.

METHODS

A retrospective study was performed of 15 cases of ganglion cyst involving the PCL treated at our institution over a period of 4 years. All the cysts were diagnosed and had their location confirmed preoperatively by magnetic resonance imaging (MRI). All the cysts were excised arthroscopically through the posterior trans-septal portal. All patients were followed up with MRI evaluation at a mean of 36 months after surgery. In addition, International Knee Documentation Committee (IKDC) scores and range of motion (ROM) were obtained preoperatively and postoperatively simultaneously with MRI to assess the surgical outcomes.

RESULTS

Most of the patients were male patients, and the mean age was 32 years. The most common presenting complaint was pain and difficulty in knee flexion. Preoperatively, the mean ROM was 3° to 110° and the mean IKDC score was 53 (range, 38 to 67; SD, 7.9). The location of the main cystic component was posterior to the PCL in 14 patients (93%) and anterior to the PCL in 1 patient (7%). After surgery, MRI evaluation at a mean follow-up time of 36 months showed no cyst recurrence. Postoperatively, the mean IKDC score was 91 (range, 70 to 99; SD, 9.3) and the mean ROM was 3° to 128°.

CONCLUSIONS

Ganglion cysts associated with the PCL can cause knee pain and limitation of knee flexion. MRI evaluation is a noninvasive method of diagnosing PCL ganglion cysts. Arthroscopic excision through the posterior trans-septal portal is a good option for relieving pain and preventing cyst recurrence.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

评估膝关节后间隔经皮入路关节镜切除后交叉韧带(PCL)相关腱鞘囊肿的临床疗效。

方法

对我院 4 年来收治的 15 例 PCL 腱鞘囊肿患者进行回顾性研究。所有囊肿均经术前磁共振成像(MRI)诊断和定位。所有囊肿均通过后间隔经皮入路关节镜切除。所有患者术后平均随访 36 个月,均行 MRI 评估。此外,同时行 MRI 评估术前和术后国际膝关节文献委员会(IKDC)评分和膝关节活动度(ROM),以评估手术效果。

结果

多数患者为男性,平均年龄 32 岁。最常见的主诉为膝关节疼痛和屈膝困难。术前 ROM 平均为 3°至 110°,IKDC 评分平均为 53(范围 38 至 67;标准差 7.9)。14 例(93%)主囊肿位于 PCL 后,1 例(7%)位于 PCL 前。术后平均随访 36 个月 MRI 评估未见囊肿复发。术后 IKDC 评分平均为 91(范围 70 至 99;标准差 9.3),ROM 平均为 3°至 128°。

结论

与 PCL 相关的腱鞘囊肿可引起膝关节疼痛和膝关节屈曲受限。MRI 评估是诊断 PCL 腱鞘囊肿的一种非侵入性方法。经后间隔经皮入路关节镜切除是缓解疼痛和预防囊肿复发的一种较好方法。

证据等级

IV 级,治疗性病例系列。

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