Klein W, Jensen K U
Department of Orthopaedic Surgery, University of Düsseldorf, F.R.G.
Arthroscopy. 1988;4(2):63-71. doi: 10.1016/s0749-8063(88)80066-5.
Between 1981 and 1986, at the Orthopaedic Clinic of the University of Düsseldorf, arthroscopic synovectomy of the knee was performed on 59 joints in 56 patients. The follow-up examination covered 45 knee joints in 43 patients (18 female and 27 male patients). The follow-up results, taken at an average of 2.7 years after the arthroscopic synovectomy, have up to now been good and equal to those achieved using the conventional technique. In this experience, arthroscopic synovectomy is a surgical procedure that places less strain on the patient in the early postoperative healing period. An arthrotomy was no longer required in the hypertrophic synovial diseases treated during this time. Fibroarthrosis, not uncommon after conventional arthrotomy, did not occur. Only a few stab incisions were necessary to reach all--in particular the posterior--knee-joint cavities. Postoperative pain was markedly reduced from a preoperative level of 16.6 points (47%) (35 maximum points possible, or 100%) to a level of 29.5 points (84%) at follow-up. Patients who experienced an open synovectomy previously in the other knee now favor the arthroscopic procedure. The majority of the patients had a range of motion between 0 and 120 degrees within the first 2 weeks after surgery. Swelling disappeared from a preoperative score of 2.9 points (19%) (15 maximal points possible, or 100%) to 12.2 points (81%). Subjectively, 78% of the patients were satisfied with the result of arthroscopic synovectomy, 7% considered the procedure a partial success, and 15% were dissatisfied.
1981年至1986年间，在杜塞尔多夫大学骨科诊所，对56例患者的59个膝关节进行了关节镜下滑膜切除术。随访检查涉及43例患者的45个膝关节（18例女性患者和27例男性患者）。关节镜下滑膜切除术后平均2.7年的随访结果至今良好，与采用传统技术取得的结果相当。根据这一经验，关节镜下滑膜切除术是一种在术后早期愈合阶段对患者造成较小压力的外科手术。在此期间治疗的肥厚性滑膜疾病不再需要切开手术。传统切开手术后常见的纤维性关节强硬并未发生。只需几个小切口就能到达所有膝关节腔，尤其是后关节腔。术后疼痛从术前的16.6分（满分35分，占47%）显著降低至随访时的2.9分（满分15分，占84%）。此前在另一个膝关节接受过开放性滑膜切除术的患者现在更倾向于关节镜手术。大多数患者在术后前两周内的活动范围在0至120度之间。肿胀程度从术前的2.9分（满分15分，占19%）降至12.2分（占81%）。主观上，78%的患者对关节镜下滑膜切除术的结果满意，7%的患者认为手术部分成功，15%的患者不满意。
