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[关节镜下腘窝囊肿内引流与囊壁切除术的疗效比较]

[Comparison of therapeutic effects of arthroscopic popliteal cyst internal drainage and capsular wall resection].

作者信息

Mei Zheng-Feng, Lei Wen-Tao, Ma Wei, Ni Ling-Zhi, Pan Guo-Biao, Han Zhi-Wei

机构信息

Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou 310009, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2023 Sep 25;36(9):833-8. doi: 10.12200/j.issn.1003-0034.2023.09.008.

Abstract

OBJECTIVE

To investigate efficacy between arthroscopic popliteal cyst drainage and arthroscopic popliteal cyst resection.

METHODS

From January 2013 to June 2021, 54 patients with popliteal cyst (Rausching-Lindgren gradeⅠto Ⅲ) were treated with arthroscopic surgery. There were 24 males and 30 females. The age ranged from 44 to 72 years old, with a mean of (62.67±6.08) years old. The course of the disease ranged from 1 to 72 months, with a mean of(15±14) months. Twenty-four patients (group A) were underwent arthroscopic internal drainage of popliteal cyst. Thirty patients (group B) were underwent arthroscopic resection of popliteal cyst. Preoperative main symptoms included knee pain, swelling, walking pain, popliteal swelling, popliteal mass and so on. After 1, 3, 6 months and 1, 2 years of surgery, routine outpatient follow-up was conducted to observe and compare the surgical time, bleeding volume, preoperative and postoperative visual analog scale (VAS), knee Lysholm score, and complications between two groups.

RESULTS

All incisions healed at one stage after operation. All 54 patients were followed up, and the duration ranged from 6 months to 2 years, with an average of (13.89±4.29) months. There was no intraoperative vascular or nerve injury. Operation time and intraoperative blood loss of the two groups:group A of (62.08±9.55) min and (8.00±1.69) ml, group B of (69.50±6.99) min and (8.70±2.00) ml. Popliteal pain, swelling, limitation of flexion and extension were significantly relieved after operation. VAS before and one month after operation between two groups:group A of 5.38±1.21 and 2.63±0.71, group B of 5.60±1.26 and 2.80±0.81. Lysholm scores of knee joint before and 6 months after operation:group A of 62.59±4.99 and 89.74±2.90, group B of 63.87±3.23 and 89.02±2.35. Knee joint function improved significantly in both groups. In group A, 4 cases had popliteal cyst at 3 months after operation, and 2 cases had small isolated cyst at 1 year after operation. There was no recurrence of cyst in group B.

CONCLUSION

The results between two arthroscopic treatments of popliteal cyst are satisfactory, and there is no significant difference in the amount of blood loss, safety, postoperative pain VAS score and knee function recovery. It is suggested that arthroscopic resection of the cyst wall should be performed when the technique is mature, especially for large cysts and septal cysts.

摘要

目的

探讨关节镜下腘窝囊肿引流术与关节镜下腘窝囊肿切除术的疗效。

方法

2013年1月至2021年6月,对54例腘窝囊肿(Rausching-Lindgren Ⅰ至Ⅲ级)患者行关节镜手术治疗。其中男性24例,女性30例。年龄44~72岁,平均(62.67±6.08)岁。病程1~72个月,平均(15±14)个月。24例患者(A组)行关节镜下腘窝囊肿内引流术。30例患者(B组)行关节镜下腘窝囊肿切除术。术前主要症状包括膝关节疼痛、肿胀、行走痛、腘窝肿胀、腘窝肿块等。术后1、3、6个月及1、2年进行常规门诊随访,观察并比较两组手术时间、出血量、术前及术后视觉模拟评分(VAS)、膝关节Lysholm评分及并发症情况。

结果

术后所有切口均一期愈合。54例患者均获随访,随访时间6个月至2年,平均(13.89±4.29)个月。术中无血管、神经损伤。两组手术时间及术中出血量:A组分别为(62.08±9.55)min和(8.00±1.69)ml,B组分别为(69.50±6.99)min和(8.70±2.00)ml。术后腘窝部疼痛、肿胀、屈伸受限明显缓解。两组术前及术后1个月VAS评分:A组分别为5.38±1.21和2.63±0.71,B组分别为5.60±1.26和2.80±0.81。两组膝关节术前及术后6个月Lysholm评分:A组分别为62.59±4.99和89.74±2.90,B组分别为63.87±3.23和89.02±2.35。两组膝关节功能均明显改善。A组术后3个月有4例腘窝囊肿复发,术后1年有2例出现小的孤立囊肿。B组囊肿无复发。

结论

两种关节镜下治疗腘窝囊肿的效果均满意,出血量、安全性、术后疼痛VAS评分及膝关节功能恢复方面差异无统计学意义。建议技术成熟时行关节镜下囊肿壁切除术,尤其对于大囊肿及分隔囊肿。

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