关节镜下治疗腘窝囊肿的后内侧双入路与单入路对比研究。
Double posteromedial portals versus single posteromedial portal for arthroscopic management of popliteal cysts.
机构信息
Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 Xiwu Road, Xi'an, 710004, Shaanxi, People's Republic of China.
出版信息
J Orthop Surg Res. 2023 Sep 4;18(1):658. doi: 10.1186/s13018-023-04132-6.
BACKGROUND
As a common disease in orthopedic clinics, popliteal cysts often coexist with intra-articular lesions. Compared with traditional open surgery, arthroscopic treatment of popliteal cysts is less traumatic, and intra-articular lesions can be treated. The 'one-way valve' mechanism of the popliteal cyst can be removed by expanding the communication between the articular cavity and the cyst to avoid cyst recurrence. In terms of arthroscopic techniques, the comparison of clinical effects between the double posteromedial portal (DPP) and single posteromedial portal (SPP) has rarely been studied. The purpose of this retrospective study was to compare the clinical effects of DPP and SPP.
METHODS
A total of 46 consecutive patients with symptomatic popliteal cysts who underwent arthroscopic treatment were included in this study and followed for approximately 1 year. All patients were divided into two groups according to the arthroscopic portals (DPP group and SPP group). The cyst size, Lysholm score and Rauschening-Lindgren (R-L) grade were evaluated before the operation for all patients, and the intra-articular lesions, operative time and complications were recorded after operation. At the last follow-up, the Lysholm score and R-L grade were recorded, and magnetic resonance imaging was used to evaluate the outcome of the cyst. The clinical data of the two groups was statistically compared and analyzed.
RESULTS
There were no significant differences in preoperative cyst size, Lysholm score or R-L grade between the two groups (P > 0.05). The operation time of the DPP group (67.52 ± 18.23 min) was longer than that of the SPP group (55.95 ± 16.40 min) (P = 0.030), but the recurrence rate of cysts in the DPP group (0%) was obviously lower than that in the SPP group (19.0%) (P = 0.046). There were no significant differences in the Lysholm score, R-L grade or complication rate between the two groups at the last follow-up (P > 0.05).
CONCLUSION
Arthroscopic treatment of popliteal cysts using double posteromedial portals was a safe and effective surgical method.
TRIAL REGISTRATION
ChiCTR, ChiCTR2200060115. Registered 19 May 2022, https://www.chictr.org.cn/showproj.html?proj=133199.
背景
腘窝囊肿作为骨科门诊的常见病，常与关节内病变并存。与传统的开放式手术相比，关节镜治疗腘窝囊肿的创伤较小，并且可以治疗关节内病变。通过扩大关节腔与囊肿之间的沟通，可以去除腘窝囊肿的“单向阀”机制，从而避免囊肿复发。在关节镜技术方面，双后内侧入路（DPP）和单后内侧入路（SPP）的临床效果比较研究较少。本回顾性研究的目的是比较 DPP 和 SPP 的临床效果。
方法
本研究共纳入 46 例接受关节镜治疗的有症状腘窝囊肿患者，随访时间约 1 年。所有患者均根据关节镜入路（DPP 组和 SPP 组）分为两组。所有患者术前均评估囊肿大小、Lysholm 评分和 Rauschening-Lindgren（R-L）分级，术后记录关节内病变、手术时间和并发症。末次随访时记录 Lysholm 评分和 R-L 分级，并采用磁共振成像评估囊肿的疗效。对两组的临床资料进行统计学比较分析。
结果
两组患者术前囊肿大小、Lysholm 评分或 R-L 分级无统计学差异（P>0.05）。DPP 组手术时间（67.52±18.23 min）长于 SPP 组（55.95±16.40 min）（P=0.030），但 DPP 组囊肿复发率（0%）明显低于 SPP 组（19.0%）（P=0.046）。末次随访时两组 Lysholm 评分、R-L 分级或并发症发生率无统计学差异（P>0.05）。
结论
关节镜下采用双后内侧入路治疗腘窝囊肿是一种安全有效的手术方法。
试验注册
ChiCTR，ChiCTR2200060115。注册于 2022 年 5 月 19 日，https://www.chictr.org.cn/showproj.html?proj=133199。
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