关节切除术

Methods. A 60-year-old man with athetoid cerebral palsy and a history of posterior occipitocerical fusion presented with quadriparesis. Salage surgery for cerical myelopathy and pseudarthrosis was performed with laminectomy and rearthrodesis using the pedicle screw system. An intraspinal cyst was identified as the main cause of the paraparesis.

一位60岁的手足徐动症样大脑麻痹患者，既往曾行后路枕颈融合术，临床表现为四肢轻瘫，影像学检查示脊髓型颈椎病和假关节形成，采用椎板切除和椎弓根钉系统关节成形术后，发现椎管内存在的囊肿是导致四肢轻瘫的主要原因。

Methods Twenty two cases of RA patients (36 knees) were treated by arthroscopic surgery.The total synovectomy and debridement using multi portal approach were performed during the operation.

2003年5月至2004年8月，我科对22 例类风湿关节炎患者36侧膝关节进行关节镜手术治疗，术中经多入路切除全关节滑膜，同时清理关节腔。

［Objective］To explore the technique of arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee and to evaluate its clinical value［Method］A total of 14 cases of pigmented villonodular synovitis of the knee were treated from January 2000 to July 2003Intraarticular excision under arthroscope with a combined application of routine intrusments and Bipolar radiofrequency was performed on all these 14 cases,and postoperative radiotherapy for diffused pigmented villonodular synovitis of the knee,13 patients were followed up for 10~45 months,and were evaluated for range of motion,pain,swelling effusion［Result］Thirteen cases according to the International Knee Documentation Committeecriteria,subjective knee score was (587+64) and (865 ±57) respectively before surgery and at the last followup［Conclusion］In case of pigmented villonodular synovitis of the knee joint,arthroscopical synovectomy can make good surgical results,and postoperative radiotherapy is an effective treatment for diffused pigmented vilionoclular synovitis of the knee

作者：王晓旭，廖瑛，黄华扬，席雅文，李朝旭，韩志关节镜；放射治疗；膝关节；滑膜炎；色素绒毛结节性摘要：［目的］探讨采用关节镜结合放射治疗膝关节色素沉着绒毛结节性滑膜炎的方法及其临床应用价值。［方法］2000年1月～2003年7月，共收治14例膝关节色素沉着绒毛结节性滑膜炎患者，采用关节镜下常规器械加双极射频进行关节内病变切除，术后弥漫性色素沉着绒毛结节性滑膜炎辅以放疗，13例通过10~45个月的随访，了解患膝活动度、疼痛、肿胀情况。［结果］13例随访患者，术前国际膝关节评分委员会膝关节功能主观评分为（587±64）分，最后随访时，IKDC膝关节功能主观评分为（865±57）分。［结论］通过关节镜能完成膝关节色素沉着绒毛结节性滑膜炎滑膜较彻底切除，对弥漫性膝关节色素沉着绒毛结节性滑膜炎辅以术后放疗是一种有效方法。

Infections of 3 cases were controled after treatment with the wound dressing and compression bandaging after local inflammation organic resection, oral Xinhuang Tablets of proprietary Chinese medicines and antibiotics; 9 cases were treated with arthroscopic joint clean-up washing , 2 case of them were treated with incision debridement combined by synovectomy arthroscopic due to inability to complete debridement ; 3 case of them were treated with temporary prosthesis replacement surgery on the infection after total knee debridement due to recurring knee swelling and rupture , filling bone cement containing sensitive antibiotics, convection to wash on the articular cavity, and second phase renovation in stable condition, finally they recoveried postoperatively and discharged.

结果：对22例出现炎症性反应的TKA术后患者，经抗感染、关节腔对流冲洗、清创和Ⅱ期再置换并配合口服中成药新癀片等处理。10例轻微肿痛病人经单纯药物治疗，症状改善。12例患者应用外科干预， 3例行局部炎症组织切除后伤口换药并加压包扎，口服中成药新癀片及抗生素治疗后控制感染；9例在关节镜下行关节清理冲洗，其中2例在行关节镜下手术时因无法彻底清创行切开清创合并滑膜切除； 3例因反复出现膝关节红肿、疼痛、甚至破溃予全膝置换术后感染清创临时假体置换术，用含敏感抗生素骨水泥填充，对关节腔进行对流冲洗，待关节情况稳定后行Ⅱ期翻修，术后痊愈出院。

The purpose of this study was to evaluate the clinical and radiographic outcomes of isolated arthroscopic biceps tenotomy or tenodesis as treatment for persistent shoulder pain and dysfunction due to an irreparable rotator cuff tear associated with a biceps lesion.

本研究的目的是评价关节镜下二头肌肌腱切除术或者腱固定术来治疗由于肩袖撕裂及其二头肌肌腱病变导致的肩部疼痛或者功能丧失。

Methods We retrospectively compared 45 cases who were retained and sutured capsula articularis during THA through posterior approach from January 2006 to May 2007 with 57 cases routinely resected capsula articularis during 2004 to 2005 on the rate of dearticulation after operation.

将2006年1月年5月的45例后路THA患者术中行关节囊保留修复，与2004年～2005年所行的后路常规行关节囊切除的THA患者57例在术后脱位发生率方面进行回顾性比较分析。

Methods selective and limited minimally invasive debridement under arthroscope was applied to 54 patients with osteoarthritis of knee joint; hyperplasia of inflammatory synovial membrane and abrasion of anterior cruciate ligament were chipped or vaporized with radiofrequency, the corpus liberum were taken out, cartilage was scoured into certain shape; excision or partial excision were performed to hyperplastic intercondyloid spine, osteophyma and menisci; intercondyloid fossa was formed.results 45 cases were followed up for an average of 18 months (from 6 months to 24 months); the clinical symptoms of most cases released obviously and the joint function improved.conclusions minimally invasive debridement under arthroscope can effectively release oa symptoms, improve joint function and raise the quality of life.

对54例膝关节骨性关节炎患者进行关节镜下选择性、有限化微创清理术。手术内容包括刨削或射频汽化增生的炎性滑膜组织和前交叉韧带磨损、游离体取出、软骨打磨成形、增生髁间棘切除、部分骨赘切除、半月板部分切除、髁间窝成形。结果随诊45例，平均18个月（6～24月），大多数患者临床症状明显缓解，关节功能改善。结论关节镜微创清理术可有效缓解oa症状，改善关节功能，提高生活质量。骨关节炎；膝关节；关节镜检查

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

He main purpose of trapeziometacarpal distraction arthroplasty is to avoid trapeziectomy, thereby leaving the length and stability of the base of the thumb intact and saving surgical and rehabilitative time.

M牵伸关节成形术的主要目的是避免大多角骨切除术，因此可以使拇指的力量和基底的稳定性得以最大程度的保留，节省外科手术和康复的时间。

A greater trochanteric osteotomy may be required.

上图之手术后 X 光是骨盆部位之腹背照和侧照，箭头处是两处未修复的部位，如发生退化性关节炎或功能性问题，可能需要进一步手术，做股关节头切除术。

This one mode pays close attention to network credence foundation of the businessman very much.

这一模式非常关注商人的网络信用基础。

Cell morphology of bacterial ghost of Pasteurella multocida was observed by scanning electron microscopy and inactivation ratio was estimated by CFU analysi.

扫描电镜观察多杀性巴氏杆菌细菌幽灵和菌落形成单位评价遗传灭活率。