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膝关节囊肿:评估与处理。

Cysts about the knee: evaluation and management.

机构信息

NYU Hospital for Joint Diseases, New York, NY, USA.

出版信息

J Am Acad Orthop Surg. 2013 Aug;21(8):469-79. doi: 10.5435/JAAOS-21-08-469.

Abstract

Popliteal (Baker) cysts, meniscal cysts, proximal tibiofibular joint cysts, and cruciate ligament ganglion cysts are cystic masses commonly found about the knee. Popliteal cysts form when a bursa swells with synovial fluid, with or without a clear inciting etiology. Presentation ranges from asymptomatic to painful, limited knee motion. Management varies based on symptomatology and etiology. Meniscal cysts form within or adjacent to the menisci. These collections of synovial fluid are thought to develop from translocation of synovial cells or extravasation of synovial fluid into the meniscus through a tear. Joint-line pain and swelling are common symptoms. Management entails partial meniscectomy with cyst decompression or excision. Proximal tibiofibular joint cysts are rare, and their etiology remains unclear. Pain and swelling secondary to local tissue invasion is common, and management consists of surgical excision. Cruciate ligament ganglion cysts have no clear etiology but are associated with mucoid degeneration of the anterior and posterior cruciate ligaments, knee trauma, and synovial translocation into these ligaments. Knee pain and limited range of motion, especially with exercise, are common presenting symptoms. In symptomatic cases, arthroscopic excision is commonly performed.

摘要

腘窝(贝克)囊肿、半月板囊肿、胫骨近端胫腓关节囊肿和交叉韧带腱鞘囊肿是常见于膝关节周围的囊性肿块。当滑液充满滑囊时,形成腘窝囊肿,有或没有明确的诱发病因。表现从无症状到疼痛、膝关节运动受限不等。治疗方案根据症状和病因而有所不同。半月板囊肿形成于半月板内或附近。这些滑液的积聚被认为是通过撕裂从滑膜细胞的易位或滑膜液的渗出进入半月板而发展而来的。关节线疼痛和肿胀是常见的症状。治疗方法包括半月板部分切除术和囊肿减压或切除术。胫骨近端胫腓关节囊肿很少见,其病因仍不清楚。局部组织侵犯引起的疼痛和肿胀很常见,治疗方法包括手术切除。交叉韧带腱鞘囊肿病因不明,但与前交叉和后交叉韧带的黏液样变性、膝关节外伤以及滑膜向这些韧带转移有关。膝关节疼痛和运动范围受限,特别是在运动时,是常见的表现症状。在有症状的情况下,常进行关节镜下切除术。

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