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腘窝囊肿不同手术方式的临床疗效比较

A comparison of clinical efficacy between different surgical approaches for popliteal cyst.

作者信息

Yang Bo, Wang Fengchun, Lou Yanhua, Li Juan, Sun Lei, Gao Lei, Liu Feng

机构信息

Department of Orthopaedics, Tai'an Central Hospital, Tai'an, Shandong, 271000, China.

出版信息

J Orthop Surg Res. 2017 Oct 25;12(1):158. doi: 10.1186/s13018-017-0659-z.

Abstract

BACKGROUND

A popliteal cyst is a benign swelling with synovial fluid located behind the knee joint. Popliteal cysts are often asymptomatic; however, symptomatic cysts may cause pain and may need surgery interventions. Here, we performed a perspective study to compare the clinical efficacy of different surgical approaches, including traditional open excision and advanced arthroscopic treatment.

METHODS

A total of 76 patients with popliteal cysts were assigned into three groups by a randomized complete block design. Group A included 32 patients (15 males and 17 females, age 55.3 ± 9.8 years) who received arthroscopic internal drainage of the cysts. Group B included 19 patients (9 males and 10 females, age 55.4 ± 7.6 years) who received open excision after arthroscopic treatment. Group C included 25 patients (11 males and 14 females, age 54.2 ± 8.5 years) who received open excision. All patients were followed up for an average of 13.7 ± 2.4 months. The following parameters were compared: the time of surgery, during surgery, the length of incision, the incision healing rate, the visual analog scale (VAS) for pain, the hospitalization time, the rate of recovery to level 0-1 cysts, the recurrence rate, and the Lysholm score.

RESULTS

Group A exhibited significant better outcomes compared to groups B and C in the length of incision (1.6 ± 0.1 cm), the incision healing rate (100%), the postoperative VAS score (2.7 ± 1.2), the hospitalization time (7.8 ± 2.8 days), and the Lysholm score at the last follow-up (85.8 ± 5.2). The recurrence rate is significantly lower in groups A (3.1%) and B (5.2%) than group C (40%) (P < 0.001).

CONCLUSIONS

Arthroscopic treatment for popliteal cysts exhibited better clinical outcomes with minimal invasion and can be recommended for future clinical interventions.

摘要

背景

腘窝囊肿是位于膝关节后方的一种含有滑液的良性肿胀。腘窝囊肿通常无症状;然而,有症状的囊肿可能会引起疼痛,可能需要手术干预。在此,我们进行了一项前瞻性研究,以比较不同手术方法的临床疗效,包括传统的开放切除和先进的关节镜治疗。

方法

采用随机完全区组设计将76例腘窝囊肿患者分为三组。A组包括32例患者(男15例,女17例,年龄55.3±9.8岁),接受关节镜下囊肿内引流术。B组包括19例患者(男9例,女10例,年龄55.4±7.6岁),在关节镜治疗后接受开放切除术。C组包括25例患者(男11例,女14例,年龄54.2±8.5岁),接受开放切除术。所有患者平均随访13.7±2.4个月。比较以下参数:手术时间、术中情况、切口长度、切口愈合率、疼痛视觉模拟评分(VAS)、住院时间、囊肿恢复至0-1级的比率、复发率和Lysholm评分。

结果

A组在切口长度(1.6±0.1cm)、切口愈合率(100%)、术后VAS评分(2.7±1.2)、住院时间(7.8±2.8天)以及最后随访时的Lysholm评分(85.8±5.2)方面,与B组和C组相比,显示出显著更好的结果。A组(3.1%)和B组(5.2%)的复发率明显低于C组(40%)(P<0.001)。

结论

关节镜治疗腘窝囊肿具有更好的临床效果,侵袭性最小,可推荐用于未来的临床干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02df/5657075/ebef664f6507/13018_2017_659_Fig1_HTML.jpg

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