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[膝关节疾病关节镜手术的当前进展与未来方向]

[Current advances and future direction of arthroscopic surgery for disorders in the knee joint].

作者信息

Yasuda K

机构信息

Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Hokkaido Igaku Zasshi. 1995 May;70(3):383-9.

PMID:7590589
Abstract

An aim of this paper is to report current advances and future direction of arthroscopic surgery for disorders in the knee joint. Recently, advances of operative techniques and improvement of surgical instruments allow almost all disorders in the knee joint cavity to be arthroscopically treated. Patients of the age greater than 3 years can undergo this surgery. Arthroscopic surgery involves release of synovial malformation, capsular strung, and postoperative adhesion, removal of free bodies, excision of benign tumors, partial synovectomy, multiple drilling or pinning of osteochondral lesions, partial or total meniscectomy, plastic resection of bony spurs, repair of the torn menisci and ligaments, reconstruction of ligaments and menisci, and etc. Arthroscopic surgery has many advantages compared with open surgery: First, more precise operation can be performed in arthroscopic surgery, resulting in better final outcome, because this surgery gives rather wider visual field for intraarticular operation. Secondly, arthroscopic surgery is less invasive. Therefore, patients have less postoperative pain and adhesion, quickly regain the normal range of knee motion, and early return to the normal activities. Thirdly, operation scar after arthroscopic surgery is more acceptable for patients from the cosmetic viewpoint. There are few disadvantages in arthroscopic surgery if well-trained surgeons carefully operate patients according to the correct indications of this surgery. In the near future, arthroscopic surgery will be more frequently and wide-spread performed in Japan. Therefore, instructional and training systems for arthroscopic surgeons should be established as soon as possible. Improvement of the hardware involving arthroscopes and surgical instruments may be one of keys for future advances of arthroscopic surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文的目的是报告膝关节疾病关节镜手术的当前进展和未来方向。最近,手术技术的进步和手术器械的改进使得膝关节腔内几乎所有疾病都能通过关节镜进行治疗。3岁以上的患者可以接受这种手术。关节镜手术包括滑膜畸形松解、关节囊挛缩松解和术后粘连松解、游离体摘除、良性肿瘤切除、部分滑膜切除术、骨软骨损伤的多次钻孔或固定、部分或全半月板切除术、骨赘的整形切除、撕裂半月板和韧带的修复、韧带和半月板重建等。与开放手术相比,关节镜手术有许多优点:首先,关节镜手术可以进行更精确的操作,最终效果更好,因为这种手术为关节内操作提供了更广阔的视野。其次,关节镜手术创伤较小。因此,患者术后疼痛和粘连较少,能迅速恢复膝关节正常活动范围,并早日恢复正常活动。第三,从美容角度看,患者更容易接受关节镜手术后的手术疤痕。如果训练有素的外科医生根据该手术的正确适应症仔细操作患者,关节镜手术几乎没有缺点。在不久的将来,关节镜手术在日本将更频繁、更广泛地开展。因此,应尽快建立关节镜外科医生的教学和培训体系。改进包括关节镜和手术器械在内的硬件可能是关节镜手术未来进展的关键之一。(摘要截断于250字)

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