Sigge W, Ellebrecht T
Klinik für Kinderchirurgie, Medizinischen Universität zu Lübeck.
Z Kinderchir. 1988 Jun;43(3):176-9. doi: 10.1055/s-2008-1043444.
63 children underwent diagnostic arthroscopy of the knee carried out under general anaesthesia, 46 of them presenting an acute haemarthrosis, 17 because of recurrent pain of effusion that developed under remobilisation stress two or more weeks after the accident. Arthroscopy provides--in addition to radiographs and stability test--complete evaluation of internal derangement of the knee. Clinical diagnosis based on examination and radiographs alone was confirmed by arthroscopy in only 25% in our series. Several arthrotomies would have been performed following "safe" clinical diagnosis, but could be avoided by use of arthroscopy; in other cases, diagnosis could be corrected, thus influencing preoperative planning. Arthroscopy improves diagnostic accuracy and eliminates a "wait-and-watch" policy of treatment. For several chondral and meniscal lesions, arthroscopic operation is the therapy of choice.
63名儿童在全身麻醉下接受了膝关节诊断性关节镜检查，其中46名表现为急性关节积血，17名是因为在事故发生两周或更长时间后，在重新活动的压力下出现反复疼痛或积液。关节镜检查——除了X线片和稳定性测试外——还能对膝关节内部紊乱进行全面评估。在我们的系列研究中，仅根据检查和X线片做出的临床诊断，经关节镜检查证实的仅占25%。按照“安全”的临床诊断本需进行多次关节切开术，但通过使用关节镜检查可以避免；在其他情况下，诊断可以得到纠正，从而影响术前规划。关节镜检查提高了诊断准确性，消除了“观察等待”的治疗策略。对于一些软骨和半月板损伤，关节镜手术是首选治疗方法。
