[1]王续鹏 郭旗 刘宁 魏岚*.关节镜下切除胫骨近端孤立性骨软骨瘤[J].中国微创外科杂志,2023,01(3):216-221.
　Wang Xupeng,Guo Qi,Liu Ning,et al.Arthroscopic Resection for the Treatment of Proximal Tibial Solitary Osteochondroma[J].Chinese Journal of Minimally Invasive Surgery,2023,01(3):216-221.
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关节镜下切除胫骨近端孤立性骨软骨瘤()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年3期
页码:
216-221
栏目:
临床研究
出版日期:
2023-03-25

文章信息/Info

Title:
Arthroscopic Resection for the Treatment of Proximal Tibial Solitary Osteochondroma
作者:
王续鹏 郭旗 刘宁 魏岚*
(河南大学附属郑州市骨科医院运动医学科，郑州450052)
Author(s):
Wang Xupeng;  Guo Qi;  Liu Ning;  et al.
Department of Sports Medicine, Zhengzhou Orthopedics Hospital Affiliated to Henan University, Zhengzhou 450052, China
关键词:
膝关节; 骨软骨瘤; 关节镜
Keywords:
Knee joint; Osteochondroma; Arthroscopy
文献标志码:
A
摘要:
目的探讨关节镜手术治疗胫骨近端孤立性骨软骨瘤的临床疗效及安全性。方法2016年10月~2021年12月我科采用关节镜手术治疗胫骨近端孤立性骨软骨瘤23例。建立关节外假性腔隙，刨削刀、射频适当清理占位周围脂肪和纤维组织，完整显露骨软骨瘤体，磨钻或骨刀切断蒂部或基底部，髓核钳完整取出游离软骨帽，将标本送病理组织学检查，射频对创面止血，然后彻底冲洗，清理组织碎屑。采用视觉模拟评分(Visual Analogue Scale，VAS)、Lysholm 评分等评价术后恢复情况。结果手术时间30~75 min，平均51.3 min。术中病理：软骨组织、破碎骨组织及纤维组织，符合骨软骨瘤。23例术后随访12～29个月，平均17.2月，无骨软骨瘤复发，无感染、静脉血栓形成、膝内侧不稳、异位骨化等并发症。末次随访术区皮肤麻木范围中位数12.0(0.0，36.0)cm2，明显小于术后3个月51.0(12.0，72.6)cm2(Z=-3.724，P=0.000)。末次随访疼痛VAS评分中位数0.8(0.0，1.0)分，显著低于术前6.0(5.5，7.0)分(Z=-4.208，P=0.000)；Lysholm评分中位数96(95，98)分，较术前75(65，80)分明显提高(Z=-4.201，P=0.000)。结论关节镜下切除胫骨近端孤立性骨软骨瘤安全有效，手术创伤小，切口美观。
Abstract:
ObjectiveTo investigate the clinical safety and efficacy of arthroscopic resection for the treatment of proximal tibial solitary osteochondroma.MethodsA total of 23 patients with solitary osteochondroma of proximal tibia treated from October 2016 to December 2021 were analyzed retrospectively. The patients were treated by minimally invasive resection of the osteochondroma under arthroscopy after creating extraarticular subcutaneous space. The osteochondroma was completely exposed and the fat and fibrous tissue around the space occupation were properly cleaned with the shaver blade and radio frequency to completely display the osteochondroma. The pedicle or base was cut off with a bur or bone knife, and the free cartilage cap was taken out completely with nucleus pulposus forceps. The specimens were sent to pathology laboratory for histopathological examination. The wound surface bleeding was stopped by radio frequency, and then thoroughly washed to remove tissue debris. Postoperative assessment included visual analogue scale (VAS) for pain and Lysholm score.ResultsThe operation time was 30-75 min, with an average of 51.3 min. Intraoperative pathology showed cartilage tissue, broken bone tissue and fibrous tissue, consistent with osteochondroma. All the 23 patients were followed up for a mean of 17.2 months (range, 12-29 months). There were no serious procedurerelated complications such as incision infection, venous thrombosis, knee medial instability or ectopic ossification, and no recurrence of osteochondroma was recorded. At the last followup, the range of skin numbness around the operation area significantly reduced as compared with that in the early postoperative period ［12.0 (0.0,36.0) cm2 vs. 51.0 (12.0,72.6) cm2, Z=-3.724, P=0.000］. Compared to the preoperative status, the VAS significantly decreased ［0.8 (0.0, 1.0) points vs. 6.0 (5.5, 7.0) points, Z=-4.208, P=0.000］ while the Lysholm score significantly increased ［96(95,98)points vs. 75(65,80)points, Z=-4.201,P=0.000］.ConclusionArthroscopic resection of proximal tibial solitary osteochondroma is safe and effective, which has benefits of less tissue trauma and good cosmetic incision.

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备注/Memo

备注/Memo:
*通讯作者，Email：13733165970@163.com
更新日期/Last Update: 2023-06-23