“4”字体位全关节镜下双后内侧入路腘窝囊肿切除术对患者膝关节功能和炎症指标的影响

Effect of arthroscopic excision of popliteal cysts via double posteromedial portals with the body position of the Chinese character of "4" on knee function and inflammatory indexes

摘要:

目的 探讨“4”字体位全关节镜下双后内侧入路腘窝囊肿切除术对患者膝关节功能和炎症指标的影响。方法 回顾性分析2019年1月－2021年10月该院收治的70例双腘窝囊肿患者的临床资料，分成观察组（n = 36）与对照组（n = 34），观察组在“4”字体位下行全关节镜下双后内侧入路腘窝囊肿切除术，对照组行传统手术。比较两组患者术前、术后炎症指标、Lysholm膝关节功能评分和日本骨科协会（JOA）评分。结果 术前两组患者白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、C反应蛋白（CRP）、Lysholm膝关节功能评分和JOA评分比较，差异均无统计学意义（P > 0.05）。术后48 h，观察组IL-6、IL-8和CRP水平较对照组明显降低（P < 0.05），Lysholm评分明显高于对照组（P < 0.05），JOA评分明显高于对照组（P < 0.05）。观察组术后并发症发生率（5.56%）明显低于对照组（23.53%）（P < 0.05），术中出血量明显少于对照组（P < 0.05），术后首次下床活动时间与住院时间均明显短于对照组（P < 0.05）。结论 “4”字体位行全关节镜下双后内侧入路腘窝囊肿切除术，有利于患者膝关节功能早期恢复，还有利于降低血清炎症因子水平。

Abstract:

Objective To investigate the effect of arthroscopic excision of popliteal cysts via double posteromedial portals with the body position of the Chinese character of “4” on knee function and inflammatory indexes.Methods Clinical data of 70 patients with popliteal cysts from January 2019 to October 2021 were retrospectively analyzed, and classified into two groups. The observation group (n = 36) received arthroscopic excision of popliteal cysts via double posteromedial portals with the body position of the Chinese character of “4”, the control group (n = 34) received traditional surgery, thereafter, the pre-and post- operative inflammatory indexes, Lysholm knee function score and Japanese Orthopedic Association (JOA) score were compared between the two groups.Results Serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP), Lysholm score and JOA score before the surgery showed no significant difference between the two groups (P > 0.05). At postoperative 48 h, the levels of IL-6, IL-8 and CRP of observation group were significantly lower than those of control group (P < 0.05), and Lysholm score and JOA score of observation group were higher than those of control group (P < 0.05). The postoperative complication rate was 5.56% in observation group, which was significantly lower than 23.53% in control group (P < 0.05). Compared with control group, observation group had significantly lower intraoperative blood loss, with statistical difference (P < 0.05), shorter first out-of-bed activity time and hospital stay length (P < 0.05).Conclusion Application of arthroscopic excision of popliteal cysts via double posteromedial portals with the body position of the Chinese character of “4” can effectively promote the functional recovery and alleviate the inflammation responses in patients.