关节镜治疗腘窝囊肿的有效性和安全性分析

Analysis of the Effectiveness and Safety of Arthroscopic Treatment for Ganglion Cysts

摘要: 目的：分析关节镜治疗腘窝囊肿的疗效及安全性。方法：回顾性分析2020年至2023年期间收治的78例腘窝囊肿患者，其中开放手术(OS)组38例，关节镜(AS)组40例。开放手术组接受传统开放性囊肿切除术，关节镜组采用关节镜下行囊肿切除并同时处理关节内病变。比较两组患者的临床资料，包括手术时间、切口长度、术中失血量、住院天数、住院费用、疼痛视觉模拟评分(VAS)、膝关节活动度、Lysholm评分、复发率及术后并发症发生情况。结果：与开放手术组相比，关节镜组在切口长度、术中失血量、住院时间及VAS评分方面均显著优于开放组；但关节镜组的手术时间及住院费用明显高于开放组。一年随访结果显示，关节镜组的Lysholm评分及囊肿复发率均明显优于开放组。在并发症方面，关节镜组术后总并发症发生率较低，显著优于开放组，但出现1例隐神经损伤。结论：关节镜手术具有创伤小、恢复快，并可同时处理关节内病变，从而降低囊肿术后复发率。此外，关节镜术后并发症发生率较低，安全性优于开放手术。但需注意关节镜手术过程中可能存在隐神经损伤的风险。

Abstract: Objectives: To analyze the efficacy and safety of arthroscopic treatment for popliteal cysts. Methods: Retrospective analysis of 78 patients with popliteal cysts admitted from 2020 to 2023, including 38 patients in the open surgery (OS) group and 40 patients in the arthroscopy (AS) group. The open surgery group underwent traditional open cystectomy, while the arthroscopy group had both intra-articular lesions and cystectomy managed arthroscopically. Clinical data, including surgical time, incision length, blood loss, hospital stay duration, cost, pain visual analog scale (VAS) score, range of motion of the knee joint, Lysholm score, recurrence rate, and postoperative complications, were collected for both groups. Results: Compared to the open surgery group, arthroscopy group showed significantly better outcomes in incision length, blood loss, length of hospitalization and VAS scores. However, the surgical time and hospitalization costs were significantly higher in the arthroscopy group. At one-year follow-up, the Lysholm score and the recurrence rate indicated that the arthroscopy group performed significantly better than the open surgery group. In terms of complications, the overall incidence of postoperative complications was lower in the arthroscopy group, although one case of saphenous nerve injury occurred postoperatively. Conclusions: Arthroscopic surgery is associated with less trauma, quicker recovery, and the ability to address intra-articular lesions, thereby reducing the recurrence of cysts postoperatively. Additionally, the incidence of complications following arthroscopy is lower, indicating higher safety compared to the open surgery group. However, the potential risk of saphenous nerve injury during arthroscopic surgery should be noted.