Abstract:

Objective　To observe, evaluate, and analyze the clinical effects of different arthroscopic operations in the treatment of patients with osteoarthritis and popliteal cyst. Methods　A total of 40 patients with osteoarthritis and popliteal cyst admitted to Department of Orthopedics, Yangjiang People's Hospital from July 2021 to March 2022 were selected and divided into a control group and an observation group according to the operations, with 20 cases in each group. There were 9 males and 11 females in the control group; they were (49.03±8.01) years old. There were 10 males and 10 females in the observation group; they were (48.91±7.59) years old. The control group were treated through the single posterior medial arthroscopic approach by valvulotomy and internal drainage, and the observation group through double posterior medial arthroscopic approaches by joint cleaning and popliteal cyst resection. The incidences of complications such as incision infection, joint infection, and vascular and nerve injury and patient satisfaction after the operation, the scores Visual Analogue Scale (VAS) and knee joint function and Rauschning-Lindgren grades before and after the operation, and the recurrence rates were compared between the two groups. Independent sample t and χ² tests were applied. Results　The incidence of postoperative wound infection, joint infection, and vascular and nerve injury in the observation group was significantly lower than that in the control group [10.00%(2/20) vs. 40.00%(8/20)], with a statistical difference (χ²=3.333, P<0.05). The VAS scores 3, 6, and 9 months after the surgery were significantly lower than those before the treatment in both groups (all P<0.05), and the scores in the observation group were significantly lower than those in the control group (all P<0.05). The knee function scores 3, 6, and 9 months after the surgery were significantly higher than those before the treatment in both groups (all P<0.05), and the scores in the observation group were significantly higher than those in the control group (all P<0.05). There were no significant changes in the Rausning-Lindgren grading in the two groups between before surgery and 3, 6, and 9 months after the surgery (all P>0.05); there were no statistical differences in the Rausning-Lindgren grading between the two groups at the corresponding time points (all P>0.05). After 12 months' follow-up, the recurrence rate of in the observation group was significantly lower than that in the control group [5% (1/20) vs. 20% (4/20)], with a statistical difference between the two groups (P<0.05). The satisfaction of the observation group was higher than that of the control group [95.00% (19/20) vs. 80.00% (16/20)], with a statistical difference (P<0.05). Conclusion　Joint clearance and popliteal cyst resection through double posterior medial arthroscopic approaches in the treatment of patients with osteoarthritis and popliteal cyst can effectively reduce the incidence of complications, and the knee function recovery effect is more satisfactory, with the advantage of a low recurrence rate and high patient satisfaction, so it is worthy of clinical promotion and application.

Key words:

Osteoarthritis, Popliteal cyst, Joint cleaning through double posterior medial arthroscopic approaches, Popliteal cyst resection

摘要：

目的　观察关节镜下不同术式治疗骨性关节炎并腘窝囊肿的临床效果。方法　采用回顾性分析，选取2021年7月至2022年3月阳江市人民医院骨科收治的40例骨性关节炎合并腘窝囊肿患者，根据手术治疗方法不同分为对照组和观察组。对照组20例，其中男9例，女11例，年龄（49.03±8.01）岁，采用关节镜后内侧单入路腘窝囊肿+活瓣切除内引流术治疗；观察组20例，其中男10例，女10例，年龄（48.91±7.59）岁，采用关节镜后内侧双入路行关节清理+腘窝囊肿切除术。比较两组术后并发症（术后切口感染、关节感染、血管神经损伤）发生率、患者满意度，比较两组患者手术前后的视觉模拟量表（VAS）评分、膝关节功能评分、Rauschning-Lindgren分级情况，术后随访观察两组复发率。采用独立样本t检验、χ²检验进行统计比较。结果　观察组术后并发症总发生率为10.00%（2/20），明显低于对照组的40.00%（8/20），差异有统计学意义（χ²=3.333，P<0.05）。两组患者术后3、6、9个月时VAS评分均显著低于治疗前（均P<0.05），且观察组显著低于对照组（均P<0.05）；两组患者术后3、6、9个月时膝关节功能评分均较治疗前明显升高（均P<0.05），且观察组显著高于对照组（均P<0.05）；两组患者术前及术后3、6、9个月Rauschning-Lindgren分级无明显改变（P>0.05），在相应时间点，两组间Rauschning-Lindgren分级差异均无统计学意义（均P>0.05）。术后随访12个月，观察组复发率为5%（1/20），低于对照组的20%（4/20），两组比较差异有统计学意义（P<0.05）；观察组患者满意度为95.00%（19/20），明显高于对照组的80.00%（16/20），差异有统计学意义（P<0.05）。结论　采用关节镜后内侧双入路行关节清理+腘窝囊肿切除术治疗骨性关节炎并腘窝囊肿，能有效降低并发症发生率，膝关节功能恢复疗效更为满意，具有复发率低的优势，患者满意度高，值得临床大力推广应用。

关键词:

骨性关节炎, 腘窝囊肿, 关节镜后内侧双入路行关节清理, 腘窝囊肿切除术