诊断不明膝关节交锁症的病因探讨和疗效观察

目的　探讨诊断不明膝关节交锁症的病因、症状特点 ,经关节镜治疗后的临床疗效。　方法　对 4 7例膝关节不明原因交锁的病例均施行关节镜检查。镜下发现的病变 :34例滑膜疾病、4例Hof fa病、9例髌股关节排列异常 ,滑膜疾病镜下刨削切除滑膜皱襞、增生肥厚的滑膜团块及滑膜瘤样病变 ,Hoffa病镜下部分切除髌下脂肪垫 ,髌骨半脱位行髌骨外侧支持带松解、胫骨结节前内侧移位。　结果　平均随访 1年 ,全部病例术后交锁症状消失 ,4 6例膝关节疼痛完全消失或明显缓解 ,术前存在膝关节功能障碍的大多数病例术后恢复或接近正常。　结论　诊断不明膝关节交锁症的原因较多 ,其主要病因是滑膜疾病、Haffa病、髌股关节排列异常。关节镜术是一个重要的诊断和治疗手段 ,并可获得满意的临床效果。

A Study on the causes and therapeutic effects of locking knee of unclear causes

Objective To study the causes and symptoms about locking knee of unclear causes and analyze the thrapeutic effects of arthroscopy. Methods Arthroscopy was performed for 47 cases who suffered from locking knee of unclear causes.The main focuses observed were synovial shelf(16 cases),synovial hyperplasia(15 cases),synovial cyst(3 cases),Hoffa disease(4 cases)and patellofemoral malalignment(9 cases).These synovial focuses were resected by arthroscopic shaving.For Hoffa disease,arthroscopic partial resection of the infrapatellar fat pad was done.For patellofemoral malalignment,the procedures consisted of a standard lateral retinacular release and distal realignment of the patella. Results All patients were followed up for 2 months to 3 years on (an average of 1 year).The locking of knee disappeared for all cases and painless of knee for 46 cases.The functional recoveries of Knee joint were mostly excellent. Conclusions The main causes consisted of synovial shelf?hyperplasia?cyst,Hoffa disease and patellofemoral malalignment for locking knee of unclear causes.Arthroscopy is not only an important diagnostic method,but also a significant procedure of treatment and the therapeutic effects are satisfactory.