原发性膝关节滑膜软骨瘤病的手术选择：系统综述

IF 2.1 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-08-13 DOI:10.1016/j.artd.2025.101796

Zhen Jonathan Liang MBBS (Hons) , Yu Liu MBBS , Vachalam Rangasamie Danakkrisna MBBS , Zi Qiang Glen Liau MBBS, MRCS, MMed (Ortho), FRCS (Ortho), FAMS (Ortho), MBA

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引用次数: 0

摘要

背景：滑膜软骨瘤病是一种罕见的良性疾病，其特征是在关节、滑囊或肌腱鞘的滑膜内形成软骨结节。虽然存在非手术治疗，但手术干预往往是必要的。本系统综述旨在评估治疗膝关节滑膜软骨瘤病的手术选择，并比较每种手术后的复发率。方法根据系统评价和荟萃分析指南的首选报告项目，使用PubMed、SCOPUS和Embase检索截至2025年4月的文献。研究包括对原发性膝关节滑膜软骨瘤病的详细手术干预。结果37项研究符合纳入标准，包括30例病例报告、4项回顾性研究和3个病例系列，涉及120例患者（男性70例，女性49例，1例未明确）。手术技术分为开放入路、关节镜入路和联合入路。开放入路包括不切除滑膜的关节切开术、部分和全部滑膜切开术以及全膝关节置换术。关节镜入路包括冲洗和滑膜切除术（部分和全部）。联合入路包括分阶段手术，包括开放手术和关节镜手术。复发率各不相同：切开关节切开术(0%；1年和20年随访)，关节镜滑膜切除术(5.71%；平均随访时间1.53年)，开腹滑膜切除术(12.5%；平均随访2.04年)，全膝关节置换术（20.8%，平均随访10.3年）和关节镜冲洗(31.4%；平均随访6.56年)。联合治疗6例无复发，平均随访1.44年。结论：本系统综述强调了不同技术复发的可变性。关节镜下滑膜切除术和联合入路复发率最低；然而，手术方法的选择应根据个别患者的情况和外科医生的专业知识而定。

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Surgical Options for Primary Synovial Chondromatosis of the Knee: A Systematic Review

Background

Synovial chondromatosis is a rare benign condition characterized by the formation of cartilaginous nodules within the synovium of joints, bursae, or tendon sheaths. While nonsurgical management exists, surgical intervention is often necessary. This systematic review aims to evaluate surgical options for managing synovial chondromatosis of the knee and compare recurrence rates following each procedure.

Methods

Adhering to the Preferred Reporting Items of Systematic Review and Meta-Analysis guidelines, a literature search was conducted using PubMed, SCOPUS, and Embase, up to April 2025. Studies included detailed surgical interventions for primary synovial chondromatosis of the knee.

Results

Thirty-seven studies met the inclusion criteria, comprising 30 case reports, 4 retrospective studies, and 3 case series, involving 120 patients (70 males, 49 females, 1 unspecified). Surgical techniques were categorized into open, arthroscopic, and combined approaches. Open approaches included arthrotomies without synovectomy, partial and total synovectomies, and total knee arthroplasty. Arthroscopic approaches involved washouts and synovectomies (partial and total). Combined approaches included staged surgeries with both open and arthroscopic techniques. Recurrence rates varied: open arthrotomy (0%; 1 and 20 year follow-up), arthroscopic synovectomy (5.71%; average follow-up duration 1.53 years), open synovectomy (12.5%; average follow-up 2.04 years), total knee arthroplasty (20.8% average follow-up 10.3 years), and arthroscopic washout (31.4%; average follow-up 6.56 years). Combined approaches reported no recurrences in 6 cases with average follow-up 1.44 years.

Conclusions

This systematic review highlights variability in recurrence across techniques. Arthroscopic synovectomy and combined approaches demonstrated the lowest recurrence; however, the choice of surgical method should be tailored to the individual patient's condition and the surgeon's expertise.

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.