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膝关节滑膜软骨瘤病:关节镜辅助下“卵石囊”摘除及滑膜切除术的治疗

Synovial Chondromatosis of the Knee Joint: Management With Arthroscopy-Assisted "Sac of Pebbles" Extraction and Synovectomy.

作者信息

Vasudevan Rajabalaji, Jayakaran Harishbabu, Ashraf Munis, Balasubramanian Navin

机构信息

Orthopedics, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, IND.

出版信息

Cureus. 2024 Sep 13;16(9):e69378. doi: 10.7759/cureus.69378. eCollection 2024 Sep.

Abstract

Synovial chondromatosis is a rare, benign condition characterized by the formation of intra-articular cartilaginous loose bodies, which arise as a result of synovial membrane metaplasia. Due to pain, edema, and joint dysfunction, synovial chondromatosis can result in severe morbidity even though it is a self-limiting condition. In order to avoid problems, such as joint degeneration, early diagnosis and treatment is essential. This case study presents a female patient, age 24, who has experienced increasing pain, swelling, and occasional locking in her left knee for the past two years. Clinical examination of the suprapatellar pouch revealed several palpable loose bodies and effusion. Several intra-articular loose bodies were confirmed by imaging techniques. The patient underwent arthroscopic removal of multiple loose bodies and synovectomy. Histopathological examination confirmed the diagnosis as primary synovial chondromatosis. Postoperatively, the patient achieved a full range of movement without pain, and recurrence was not observed after three months of follow-up. For the treatment of knee synovial chondromatosis, an efficient and less invasive method is the arthroscopy-assisted removal of loose bodies and synovectomy. The value of this method in treating this uncommon condition is emphasized by the significant functional recovery and the lowered risk of recurrence.

摘要

滑膜软骨瘤病是一种罕见的良性疾病,其特征是关节内形成软骨游离体,这是滑膜化生的结果。尽管滑膜软骨瘤病是一种自限性疾病,但由于疼痛、水肿和关节功能障碍,它仍可导致严重的发病率。为了避免诸如关节退变等问题,早期诊断和治疗至关重要。本病例研究介绍了一名24岁女性患者,在过去两年中,她左膝的疼痛、肿胀和偶尔的交锁症状不断加重。髌上囊的临床检查发现了几个可触及的游离体和积液。影像学检查证实了关节内有多个游离体。该患者接受了关节镜下多个游离体切除术和滑膜切除术。组织病理学检查确诊为原发性滑膜软骨瘤病。术后,患者实现了无痛的全范围活动,随访三个月后未观察到复发。对于膝关节滑膜软骨瘤病的治疗,一种有效且侵入性较小的方法是关节镜辅助下的游离体切除术和滑膜切除术。这种方法在治疗这种罕见疾病中的价值体现在显著的功能恢复和降低的复发风险上。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef6c/11473246/2384ed502370/cureus-0016-00000069378-i01.jpg

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