Ten-Zone Divisional Method of the Knee Joint and Its Application to Arthroscopic Total Synovectomy for Rheumatoid Arthritis
- VernacularTitle:膝关节十分区法及其在类风湿关节炎关节镜下滑膜全切除除术中的应用
- Author:
Liheng ZHAO
;
Jiakuo YU
;
Hao LUO
- Publication Type:Journal Article
- Keywords:
Rheumatoid arthritis;
Synovectomy;
Arthroscopy;
Septum
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish a ten-zone divisional method of the knee joint and investigate its clinical application to arthroscopic total synovectomy for rheumatoid arthritis (RA). Methods A total of 22 fresh frozen specimens of adult knee joints were prepared for anatomical study on the sagittal septum of the knee to establish ten-zone divisional method of the knee joint. A retrospective study was carried out on 37 patients with early-stage RA (40 knees) undergone arthroscopic total synovectomy. Among the cases,15 knees were operated according to ten-zone divisional method; and the other 25 were treated with the routine method. The patients were followed up for 10-72 months to evaluate their Lysholm score,Lequesne Index,and Larsen stage classification. Results There was a sagittal septum in the knees,connecting anteriorly to the fat pad,alar fold,or mucous ligament. The middle part of the sagittal septum lied between the anterior and posterior cruciate ligaments,and its posterior part formed the posterior septum of the knee. Considering the anatomy of the sagittal septum,the synovium of the knee could be divided into 10 zones. All of the patients underwent total synovectomy by ten-zone divisional method achieved excellent or good outcomes (100%,15/15),none of them recurred during follow-up. Among the 25 knees that received total synovectomy by routine arthroscopic method,17 achieved excellent or good outcomes (68%,17/25),and 8 had recurrence (Fisher's exact test,P=0.016). Conclusions Arthroscopic total synovectomy was one of the effective treatments for early-stage RA. The ten-zone divisional method for total synovectomy according to the structure of the knee sagittal septum could improve the clinical results of total synovectomy for rheumatoid arthritis.
