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距下关节镜清创术治疗跗骨窦综合征:病例系列

Subtalar arthroscopic debridment for the treatment of sinus tarsi syndrome: case series.

作者信息

Mansur Nacime Salomão Barbachan, Baumfeld Tiago Soares, Lemos André Vitor Kerber Cavalcante, Azevedo Rafael Mohriak de, Fonseca Lucas Furtado da, Doering Juliana, Nery Caio Augusto Souza

机构信息

Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, SP, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2019 Mar;65(3):370-374. doi: 10.1590/1806-9282.65.3.370. Epub 2019 Apr 11.

Abstract

OBJECTIVE

The objective of this study is to report the results of arthroscopic debridement of the subtalar joint in eight patients with Sinus Tarsi Syndrome (STS) refractory to conservative treatment.

METHODS

This is a retrospective study of eight patients with STS who underwent subtalar arthroscopy for debridement of the sinus tarsi between January 2015 and January 2017 after six months of conservative treatment. All patients answered an epidemiological questionnaire and underwent functional evaluation with the Visual Analogue Pain Scale (VAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) in the preoperative and in the last evaluation (average of 12 months - 6-24 months).

RESULTS

All patients showed severe synovitis in the region. Seven patients had remnants of the talocalcaneal ligaments and six of the cervical ligament. AOFAS increased by 30 points on average (51.75 in the preoperative period to 82.62 in the last follow-up) and the VAS decreased on average by 5 points (7.37 preoperatively to 2.12 in the last follow-up). These results were statistically significant with p = 0.043 and p = 0.032 respectively. Six patients described the result as excellent and two as good. No complications were reported. All patients returned to sports after six months of follow-up.

CONCLUSION

The arthroscopic debridement of the subtalar joint is an effective and safe alternative in the treatment of STS refractory to conservative treatment. More studies, with a prospective methodology, are necessary to prove the results of this technique.

摘要

目的

本研究旨在报告对8例经保守治疗无效的距下窦综合征(STS)患者行关节镜下距下关节清创术的结果。

方法

这是一项对8例STS患者的回顾性研究,这些患者在经过6个月的保守治疗后,于2015年1月至2017年1月接受了距下关节镜检查以清理距下窦。所有患者均回答了一份流行病学调查问卷,并在术前及最后一次评估(平均12个月 - 6 - 24个月)时采用视觉模拟疼痛量表(VAS)和美国矫形足踝协会评分(AOFAS)进行功能评估。

结果

所有患者该区域均表现为严重滑膜炎。7例患者有距跟韧带残余,6例有颈韧带残余。AOFAS平均提高了30分(术前为51.75,最后一次随访时为82.62),VAS平均降低了5分(术前为7.37,最后一次随访时为2.12)。这些结果具有统计学意义,p值分别为0.043和0.032。6例患者将结果描述为优秀,2例为良好。未报告并发症。所有患者在随访6个月后恢复运动。

结论

关节镜下距下关节清创术是治疗保守治疗无效的STS的一种有效且安全的选择。需要更多采用前瞻性方法的研究来证实该技术的结果。

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