关节镜下治疗髋关节滑膜软骨瘤的疗效观察

发布时间：2018-11-09 13:25

【摘要】：目的总结关节镜下治疗髋关节滑膜软骨瘤的疗效。方法2012年4月—2015年9月,共32例髋关节滑膜软骨瘤患者于关节镜下行清除术。男19例,女13例;年龄22~64岁,平均42.1岁。左髋17例,右髋15例。患者主要临床表现为髋关节疼痛、肿胀,其中合并髋关节绞锁6例,下肢无力2例,髋关节弹响1例。"4"字试验阳性9例,Thomas征阳性4例,屈曲滚动试验阳性2例。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间16~48个月,平均33.8个月。患者疼痛症状均明显缓解或消失,VAS评分由术前的(4.8±1.2)分降至末次随访时的(1.4±0.8)分,比较差异有统计学意义(t=6.382,P=0.013);髋关节功能明显恢复,Harris评分由术前的(63.2±8.3)分提高至末次随访时的(92.6±6.7)分,比较差异有统计学意义(t=9.761,P=0.006)。末次随访时3例"4"字试验阳性,1例Thomas征阳性,其余患者无明显阳性体征。X线片复查示患者均无复发征象。结论关节镜下治疗髋关节滑膜软骨瘤创伤小、清理彻底、术后恢复快,近期疗效确切。
[Abstract]:Objective to summarize the effect of arthroscopic treatment of synovial chondroma of hip joint. Methods from April 2012 to September 2015, 32 patients with synovial chondroma of hip joint were treated with arthroscopic debridement. There were 19 males and 13 females, aged 2264 years (mean 42.1 years). Left hip 17 cases, right hip 15 cases. The main clinical manifestations of the patients were pain and swelling of the hip joint, including 6 cases with strangulation of the hip joint, 2 cases with lower extremity weakness, 1 case with elastic sound of the hip joint, 9 cases with "4" test positive, 4 cases with Thomas sign positive, and 2 cases with flexion rolling test. Results all the incisions healed in one stage. All patients were followed up for 16 ~ 48 months (mean 33.8 months). The pain symptoms were relieved or disappeared, the VAS score decreased from (4.8 卤1. 2) to (1.4 卤0. 8) at the last follow-up, and the difference was statistically significant (t = 6. 382, P < 0. 013). The hip function recovered obviously, the Harris score increased from (63.2 卤8.3) to (92.6 卤6.7) at the last follow-up, the difference was statistically significant (t 9.761). At the last follow-up, "4" test was positive in 3 cases, Thomas sign was positive in 1 case, and no obvious positive signs were found in the other patients. X-ray examination showed that there were no recurrence signs in all the patients. Conclusion arthroscopic treatment of synovial chondroma of hip joint has the advantages of small trauma, complete cleaning, quick postoperative recovery and accurate short-term curative effect.
【作者单位】：中国人民解放军总医院骨科;
【分类号】：R738

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