摘要:
Objective To discuss the clinical and imaging characters of synovial chondromatosis of hip joint, and evaluate the individual surgical treatment. Methods The current study reviewed seven patients with synovial chondromatosis of the hip who underwent surgical treatment between January, 2001 and June, 2011. By identification of the surgical indications, the optimal surgical approach alternatives were synovectomy, debridement, and arthroplasty by open arthrotomy, or arthroscopic surgery. All cases were followed up. Results According to the extent of the lesion, two patients underwent arthroscopic surgery and two patients underwent open synovectomy and removal of loose bodies. Harris hip scores improved from a preoperative mean of 49. 3 points (range ,42-56rnpoints) to a mean of 89. 5 points (range, 86-92 points) at the latest follow-up (P < 0. 05) . No more hip snap or locking was found during follow-up period. The progression of osteoarthritis was determined by Kellgren and Lawrence grading scale. One of the four patients showed progression of the Kellgren and Lawrence grade, from grade 2 to grade 3. The other three patients with severe arthritis underwent hip arthroplasty, and the Harris hip scores improved from a preoperative mean of 34. 3 points (range, 32 -36 points) to a mean of 90. 3 points (range ,88-92 points) at the latest follow-up. Conclusions Careful selection of patients, thorough preoperative imaging studies,and identification of different indications for different surgical treatments can help patient achieve recovery with few complications, and prevent further recurrence as well.%目的 探讨髋关节滑膜软骨瘤病的临床、影像学表现、手术治疗方案的选择及其术后疗效.方法 对本组2001年1月到2011年6月间收治的7例髋关节的滑膜软骨瘤病例因应病变程度差异分别采用关节镜或开放手术下关节滑膜切除,游离体清除以及人工髋关节置换等治疗手段,就术前临床表现、影像学资料进行回顾性总结,并对术后疗效进行追踪随访.结果 2例滑膜病变及游离体局限者采取关节镜下手术,2例关节内游离体分布及滑膜病变较为广泛行开放手术清理,Harris评分由术前平均49.3分(42~56分)改善为术后末次随访平均89.5分(86~92分),髋关节活动未再有弹响或交锁情况.上述4例,就骨关节炎进展作评估,采用Kellgren 和Lawrence评级,术前1级者2例,末次随访评级均维持1级;术前2级者2例中1例末次随访升至3级.另3例合并严重骨性关节炎,行人工髋关节置换,术前Harris评分平均34.3分(32~36分),末次随访评分平均90.3分(88~92分).结论 认真地辨析病例特点,完善的术前影像学检查评估,因应实际选择不同术式,可获得良好治疗效果.