ARTHROSCOPIC RESECTION OF BENIGN TUMOR IN THE KNEE POSTERIOR SEPTUM_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DAIZhu ,  CHENZhiwei , LIAOYing , FANWeijie

Department of Orthopaedics, the First Affiliated Hospital of University of South China, Hengyang Hunan, 421001, P. R. China;

Corresponding?author：

CHENZhiwei, Email: czwnhfy@hotmail.com

Keywords：

Arthroscope; Knee posterior septum; Benign tumor

DOI：

10.7507/1002-1892.20150061

Video：

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Objective To explore the technique of arthroscopic resection of benign tumor in the knee posterior septum and to evaluate its clinical results. Methods Between June 2008 and June 2012, 12 cases of benign tumor in the knee posterior septum were treated by arthroscopic surgery. There were 8 males and 4 females with an average age of 36.5 years (range, 22-50 years). The average disease duration was 8.4 months (range, 3 months to 2 years). Of 12 cases, there were 2 cases of chronic synovitis, 5 cases of ganglion, 4 cases of tenosynovial giant cell tumor, and 1 case of synovial hemangioma; solitary tumor involved in the knee posterior septum in 10 cases, and in the posterior septum and other part of the knee in 2 cases. All the patients underwent tumor removal under arthroscope with routine anterolateral and anteromedial portal, additional posteromedial portal and/or posterolateral portal. Trans-septal approach was used in 6 cases because the tumors located in the middle of the posterior septum. Results All wounds healed by first intention with no complications such as infection, haematoma in the knee, injury of vessels and nerves, deep vein thrombosis, osteofascial compartment syndrome, or cutaneous necrosis. All patients were followed up 12-46 months with an average of 18.5 months. All patients achieved relief of knee pain and improvement of knee movement. The range of motion of the knee was significantly improved from (57.08±12.52)° at pre-operation to (120.83±13.95)° at last follow-up (t=-12.84, P=0.00). The visual analogue scale (VAS) score was significantly reduced from 5.00±1.04 at pre-operation to 1.50±0.91 at last follow-up (t=-18.00, P=0.00). The Lysholm score was significantly improved from 49.50±9.07 at pre-operation to 84.58±6.82 at last follow-up (t=-8.04, P=0.00). Conclusion The benign tumor in the knee posterior septum can be completely resected under arthroscope, and the procedure is minimally invasive and useful to the restore knee function.

Citation： DAIZhu, CHENZhiwei, LIAOYing, FANWeijie. ARTHROSCOPIC RESECTION OF BENIGN TUMOR IN THE KNEE POSTERIOR SEPTUM. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(3): 284-287. doi: 10.7507/1002-1892.20150061 Copy

1.	Pace JL, Wahl CJ. Arthroscopy of the posterior knee compartments:neurovascular anatomic relationships during arthroscopic transverse capsulotomy. Arthroscopy, 2010, 26(5):637-642.
2.	Ramos LA, Astur D, Novaretti JV, et al. An anatomic study of the posterior septum of the knee. Arthroscopy, 2012, 28(1):100-104.
3.	Lee JH, Wang SI. A tenosynovial giant cell tumor arising from femoral attachment of the anterior cruciate ligament. Clin Orthop Surg, 2014, 6(2):242-244.
4.	Tsai TY, Yang YS, Tseng FJ, et al. Arthroscopic excision of ganglion cysts of the posterior cruciate ligaments using posterior trans-septal portal. Arthroscopy, 2012, 28(1):95-99.
5.	Kyung BS, Lee SH, Han SB, et al. Arthroscopic treatment of synovial chondromatosis at the knee posterior septum using a trans-septal approach:report of two cases. Knee, 2012, 19(5):732-735.
6.	Ohishi T, Takahashi M, Matsuyama Y. Osteochondritis dissecans with a large osteochondral free body in the posterolateral compartment of the knee:a case report. Knee, 2014, 21(2):620-623.
7.	桂鑒超, 王黎明, 張昊偉, 等. 跨膝關節后縱隔入路的建立及臨床應用. 中華外科雜志, 2006, 44(16):1106-1110.
8.	孫金鵬, 熊依林, 雷光華. 膝關節后縱隔解剖特點及其在關節鏡手術中的應用. 中國修復重建外科雜志, 2013, 27(2):233-235.
9.	戴祝, 陳志偉, 廖瑛, 等. 關節鏡下滑膜全切術治療膝關節慢性滑膜炎. 中國矯形外科雜志, 2012, 20(23):2117-2120.
10.	戴祝, 陳志偉, 廖瑛. 大腿肌萎縮對半月板成形或縫合后療效的影響. 中國內鏡雜志, 2013, 19(9):910-913.
11.	羅浩, 余家闊. 膝關節后縱隔與后交叉韌帶下止點的解剖關系及臨床意義. 解剖學報, 2010, 41(4):616-619.
12.	Kim SJ, Song HT, Moon HK, et al. The safe establishment of a transseptal portal in the posterior knee. Knee Surg Sports Traumatol Arthrosc, 2011, 19(8):1320-1325.
13.	Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments:a series of 31 cases and review of the literature. BMC Musculoskelet Disord, 2012, 13:137.
14.	Yoo JH, Kim EH, Min KD, et al. Arthroscopic excision of the ganglion in the posterior septum by posterior trans-septal portal:report of two cases. Arch Orthop Trauma Surg, 2009, 129(8):1047-1051.
15.	Lee YS, Ahn JH, Min BH, et al. Arthroscopic loose body removal and cyst decompression using a posterior trans-septal portal in the blind spot during knee arthroscopy-technical report. Knee, 2011, 18(1):55-58.
16.	陳志偉, 伍俊星, 梁先勇, 等. 關節鏡下治療內側半月板后角聯合外側半月板前角損傷療效. 中國修復重建外科雜志, 2014, 28(4):438-441.
17.	陸偉, 王大平, 李頂夫, 等. 全鏡下后正中入路固定后交叉韌帶下止點撕脫骨折的臨床研究. 中華關節外科雜志(電子版), 2010, 4(6):755-760.
18.	歐陽植松, 李棋, 李箭. 經膝后正中小切口可吸收螺釘固定治療后交叉韌帶脛骨止點撕脫骨折. 中國骨傷, 2013, 26(9):720-723.

1. Pace JL, Wahl CJ. Arthroscopy of the posterior knee compartments:neurovascular anatomic relationships during arthroscopic transverse capsulotomy. Arthroscopy, 2010, 26(5):637-642.
2. Ramos LA, Astur D, Novaretti JV, et al. An anatomic study of the posterior septum of the knee. Arthroscopy, 2012, 28(1):100-104.
3. Lee JH, Wang SI. A tenosynovial giant cell tumor arising from femoral attachment of the anterior cruciate ligament. Clin Orthop Surg, 2014, 6(2):242-244.
4. Tsai TY, Yang YS, Tseng FJ, et al. Arthroscopic excision of ganglion cysts of the posterior cruciate ligaments using posterior trans-septal portal. Arthroscopy, 2012, 28(1):95-99.
5. Kyung BS, Lee SH, Han SB, et al. Arthroscopic treatment of synovial chondromatosis at the knee posterior septum using a trans-septal approach:report of two cases. Knee, 2012, 19(5):732-735.
6. Ohishi T, Takahashi M, Matsuyama Y. Osteochondritis dissecans with a large osteochondral free body in the posterolateral compartment of the knee:a case report. Knee, 2014, 21(2):620-623.
7. 桂鑒超, 王黎明, 張昊偉, 等. 跨膝關節后縱隔入路的建立及臨床應用. 中華外科雜志, 2006, 44(16):1106-1110.
8. 孫金鵬, 熊依林, 雷光華. 膝關節后縱隔解剖特點及其在關節鏡手術中的應用. 中國修復重建外科雜志, 2013, 27(2):233-235.
9. 戴祝, 陳志偉, 廖瑛, 等. 關節鏡下滑膜全切術治療膝關節慢性滑膜炎. 中國矯形外科雜志, 2012, 20(23):2117-2120.
10. 戴祝, 陳志偉, 廖瑛. 大腿肌萎縮對半月板成形或縫合后療效的影響. 中國內鏡雜志, 2013, 19(9):910-913.
11. 羅浩, 余家闊. 膝關節后縱隔與后交叉韌帶下止點的解剖關系及臨床意義. 解剖學報, 2010, 41(4):616-619.
12. Kim SJ, Song HT, Moon HK, et al. The safe establishment of a transseptal portal in the posterior knee. Knee Surg Sports Traumatol Arthrosc, 2011, 19(8):1320-1325.
13. Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments:a series of 31 cases and review of the literature. BMC Musculoskelet Disord, 2012, 13:137.
14. Yoo JH, Kim EH, Min KD, et al. Arthroscopic excision of the ganglion in the posterior septum by posterior trans-septal portal:report of two cases. Arch Orthop Trauma Surg, 2009, 129(8):1047-1051.
15. Lee YS, Ahn JH, Min BH, et al. Arthroscopic loose body removal and cyst decompression using a posterior trans-septal portal in the blind spot during knee arthroscopy-technical report. Knee, 2011, 18(1):55-58.
16. 陳志偉, 伍俊星, 梁先勇, 等. 關節鏡下治療內側半月板后角聯合外側半月板前角損傷療效. 中國修復重建外科雜志, 2014, 28(4):438-441.
17. 陸偉, 王大平, 李頂夫, 等. 全鏡下后正中入路固定后交叉韌帶下止點撕脫骨折的臨床研究. 中華關節外科雜志(電子版), 2010, 4(6):755-760.
18. 歐陽植松, 李棋, 李箭. 經膝后正中小切口可吸收螺釘固定治療后交叉韌帶脛骨止點撕脫骨折. 中國骨傷, 2013, 26(9):720-723.

Chinese Journal of Reparative and Reconstructive Surgery

ARTHROSCOPIC RESECTION OF BENIGN TUMOR IN THE KNEE POSTERIOR SEPTUM

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