Hulet C, Schiltz D, Locker B, Beguin J, Vielpeau C
Département d'Orthopédie, CHU de Caen.
Rev Chir Orthop Reparatrice Appar Mot. 1998 Oct;84(6):531-8.
A retrospective study was performed on 122 patients with 124 lateral meniscal cysts, selected from a series of 8100 knee arthroscopies (1.5 per cent). Eight of the patients were lost for follow up, 11 patients had chronic anterior cruciate ligament deficiency or previous medial meniscectomy. Therefore 105 of 124 patients were included in this study. Average follow-up was 5 years (range of 1 to 12.5 years).
Mean age was 33 years (range of 12 to 69 years). All patients had pain over the joint line with a palpable mass. All were noted to have a meniscal tear at the time of surgery and 60 (57 per cent) had a horizontal cleavage component. They were all arthroscopically treated.
Meniscal tears were treated by arthroscopic partial meniscectomy in 104 cases and meniscal repair in one case. Cysts were treated by intra-articular debridement in 91 cases and open cystremoval in 14 cases. Eleven cysts recurred and a second arthroscopy was required. The clinical results, including cysts recurrence, were excellent or good in 87 per cent of cases. Osteoarthritis following treatment of these meniscal cysts occurred in 9 per cent of cases.
When there is a cyst and no other intra-articular damage, the prognosis was excellent at 5 year follow-up. For lateral meniscal cysts; arthroscopic partial meniscectomy with intra-articular debridement yields predictable results.
对从8100例膝关节镜检查(占1.5%)中选出的122例患有124个外侧半月板囊肿的患者进行了一项回顾性研究。8例患者失访,11例患者患有慢性前交叉韧带损伤或既往有内侧半月板切除术史。因此,本研究纳入了124例患者中的105例。平均随访时间为5年(范围为1至12.5年)。
平均年龄为33岁(范围为12至69岁)。所有患者在关节线上方有疼痛且可触及肿块。所有患者在手术时均被发现有半月板撕裂,其中60例(57%)有水平劈裂成分。他们均接受了关节镜治疗。
104例半月板撕裂通过关节镜下部分半月板切除术治疗,1例进行了半月板修复。91例囊肿通过关节内清创术治疗,14例进行了开放性囊肿切除术。11个囊肿复发,需要再次进行关节镜检查。包括囊肿复发在内的临床结果在87%的病例中为优或良。这些半月板囊肿治疗后9%的病例发生了骨关节炎。
当存在囊肿且无其他关节内损伤时,5年随访的预后良好。对于外侧半月板囊肿,关节镜下部分半月板切除术联合关节内清创术可产生可预测的结果。