贝克氏囊肿破裂的诊断和手术治疗：前瞻性研究

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2024-11-01 DOI:10.1016/j.jcot.2024.102792

Murodjon E. Irismetov , Kudratbek K. Tursunov , Kobiljon T. Khudayberdiev , Markhabo A. Tursunova , Yulia Roitblat

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引用次数: 0

摘要

目的我们评估了与完整的贝克氏囊肿病例（IBC）相比，破裂的贝克氏囊肿（RBC）病例在诊断和关节镜手术方面可能遇到的挑战。要探讨的主要问题是RBC 关节镜手术是否比 IBS 手术更复杂？方法该前瞻性队列研究分析了 100 名被诊断为 RBC 的手术患者（43% 为女性；平均年龄为 61 ± 9.5 岁）（2005-2022；随访至 2023 年 8 月）。对比组包括 100 名 IBC 手术患者（48% 为女性；平均年龄为 57 ± 12.5 岁）。我们对诊断难题、手术方法、功能结果、术后并发症和复发率、手术和固定时间以及康复时间进行了比较。结果在统计学上有显著意义的是，在与血栓性静脉炎进行鉴别诊断时（28 对 17，P = 0.04）和通过 99m-Tc-MDP 放射摄影检查（30 对 10，P = 0.03）更经常发现 RBC。他们经常采用三孔关节镜方法（89 对 71，p = 0.04），保留囊壁（p = 0.03），康复时间缩短了 8 天（p = 0.05）。结论如果采用关节镜技术，RBC 不会给外科医生带来额外的挑战，但诊断过程可能具有挑战性。大多数 RBC 需要采用三孔关节镜方法，并允许保留囊壁。

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Diagnostics and surgical treatment of ruptured Baker's cysts: A prospective study

Aims

We assessed diagnostic and arthroscopic surgery challenges the ruptured Baker's cysts (RBC) cases may present compared to intact Baker's cyst cases (IBC). The main question to explore was: Is RBC arthroscopic surgery more complex than IBS surgery? The null hypothesis was that RBC cases might present additional, and specific challenges for a surgeon and the arthroscopic procedure may be more complicated.

Methods

The prospective cohort study analyzed 100 operated patients (43 % female; mean age 61 ± 9.5 years) (2005–2022; follow-up to August 2023) diagnosed with RBC. The comparison group consisted of 100 operated patients (48 % female; mean age 57 ± 12.5 years) with IBC. We compared diagnostic challenges, surgical approaches, functional outcomes, the rates of postsurgical complications and recurrence, durations of surgery and immobilization, and the time to recovery.

Results

Among statistically significant results, RBCs were more frequently detected during the differential diagnosis with thrombophlebitis (28 vs. 17, p = 0.04) and by 99m-Tc-MDP radiography (30 vs. 10, p = 0.03). They frequently involved a three-port arthroscopic approach (89 vs. 71, p = 0.04), the cyst wall preservation (p = 0.03), and had the eight-day shorter time to recovery (p = 0.05). Other above-mentioned variables were similar in both groups of patients.

Conclusion

RBCs do not present an additional challenge for a surgeon if an arthroscopic technique is used, but the diagnostic process may be challenging. Most RBCs require a three-port arthroscopic approach and permit cyst wall preservation.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.