- 期刊
THE BENEFiIT OF ARTHROSCOPY FOR SYMPTOMATIC TOTAL KNEE ARTHROPLASTY
關節鏡手術對於治療有症狀之全人工膝關節置換術之成效
摘要
31個全人工膝關節置換術後仍有症狀的病患，經過關節鏡診斷與治療後發現18個膝關節內發現在關節腔不同的部位有軟組織嵌入的情形。16位病患之患側手術後仍有疼痛的症狀，而且膝關節活動範圍大於90度。關節鏡下發現這類病患之膝關節內有明顯的滑掖囊膜增生性發炎現象。然而，另有15位病患其疼痛症狀較不明顯，但是有膝關節活動範圍不良且小於90度的情形。這類病患在關節鏡下易發現以纖維組識為主。經過關節鏡手術治療後，平均膝關節活動範圍初期改善43.1度，最終追蹤時改善20度。 90.3%的病患其疼痛症狀改善，有58.1%的病患滿意關節鏡手術後的效果。對於治療有症狀之全人工膝關節置換術的病例，關節鏡手術的優點包括有助於診斷關節內病變；標本取得作為組識病理分析；對於疑似感染病例取得標本作為細菌培養；以及改善膝關節活動範圍。因此我們認為，對於這類病患之治療，關節鏡手術是一種可靠；安全及有效的方法。
並列摘要
Thirty-one knees with symptomatic total knee arthroplasty were diagnosed and treated arthroscopically. There were 18 knees with soft tissue impingement and 13 knees without. There were 16 knees with painful arthroplasty and range of motion (ROM) greater than 90°. Hypertrophied synovitis with or without impingement was more easily found by arthroscopy in this group than in the other 15 knees with the chief complaint of limited ROM, where more remarkable fibrotic tissue with intra-articular adhesion was found. Overall, the average improvement in ROM was 43.1° immediately after arthroscopy, and 20° atthe final follow-up. Symptoms improved in 90.3% of patients, and 58.1% were satisfied with the outcome of their surgery. Arthroscopy is helpful for intra-articular diagnosis, obtaining a specimen for histopathologic analysis, culture for subclinical infection, and better improvement in ROM. In our experience, arthroscopy for symptomatic knee arthroplasty is reliable, safe and effective.
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