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关节镜下诊断与治疗膝关节滑膜软骨瘤病 |
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陈坚 杜莉如 谷国良 倪磊
【摘要】目的报道膝关节滑膜软骨瘤病15例，均用关节镜诊断及治疗，所有病例均经病理检查证实。作者对关节镜在本病诊断中的优点、分型及治疗方法进行探讨。方法所有15例病例均为膝关节病变，左膝关节6例，右膝关节7例，双侧膝关节2例。主要临床症状为关节疼痛、交锁及反复肿胀。关节镜术野好，可全面检查关节腔，具有放大作用，可提高本病的诊断率并有助于分型，关节镜下可将本病分为三型：表浅型、深在型和游离体型。治疗采用关节镜下游离体取出术、局限性滑膜切除术和并发退行性关节病变者行关节清理术。结果随访12例，平均3.2年，所有病例术后功能良好，未见复发。结论关节镜有助于本病的诊断与治疗，关节镜下取出游离体及切除异常滑膜组织是治疗本病的良好手段。
【关键词】软骨瘤病，滑膜 膝关节关 节镜检查
Arthroscopic Diagnosis and Treatment of Synovial Chondromatosis of the Knee
CHEN Jian,DU Liru,GU Guoliang,et al.
Arthritis Clinical and Research Center,People’s Hospital,Beijing Medical University,Beijing 100044
【Abstract】 Objective Arthroscopy was performed in 15 patients with synovial chondromatosis of the knee.The diagnosis was all confirmed by pathologic examination.Methods The lesion involved the left knee in 6 cases and 7 in the right knee，2 cases had bilateral lesions.The main symptoms were pain,locking and recurrent swelling.Three patterns of distinct arthroscopic appearances were noted:superficial lesion,deep lesion and loose body lesion.Arthroscopic management included removal of loose bodies,limited synovectomy and treatment of degenerative joint disease.Results Twelve patients were followed-up for an average of 3.2 years. Good function was seen in all and there was no recurrence.Conclusion The authors emphasize that arthroscopy is helpful for the establishment of the diagnosis and treatment.Arthroscopic removal of all loose bodies and all abnormal synovial tissue is the treatment choice for synovial chondromatosis of the knee.
【Key words】 Chondromatosis，synovial Knee joint Arthroscopy
滑膜软骨瘤病（synovial chondromatosis）是一种较少见的滑膜增
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