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.	桂鉴超, 王黎明, 张昊伟, 等. 跨膝关节后纵隔入路的建立及临床应用. 中华外科杂志, 2006, 44(16):1106-1110.
8.	孙金鹏, 熊依林, 雷光华. 膝关节后纵隔解剖特点及其在关节镜手术中的应用. 中国修复重建外科杂志, 2013, 27(2):233-235.
9.	戴祝, 陈志伟, 廖瑛, 等. 关节镜下滑膜全切术治疗膝关节慢性滑膜炎. 中国矫形外科杂志, 2012, 20(23):2117-2120.
10.	戴祝, 陈志伟, 廖瑛. 大腿肌萎缩对半月板成形或缝合后疗效的影响. 中国内镜杂志, 2013, 19(9):910-913.
11.	罗浩, 余家阔. 膝关节后纵隔与后交叉韧带下止点的解剖关系及临床意义. 解剖学报, 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.	陈志伟, 伍俊星, 梁先勇, 等. 关节镜下治疗内侧半月板后角联合外侧半月板前角损伤疗效. 中国修复重建外科杂志, 2014, 28(4):438-441.
17.	陆伟, 王大平, 李顶夫, 等. 全镜下后正中入路固定后交叉韧带下止点撕脱骨折的临床研究. 中华关节外科杂志(电子版), 2010, 4(6):755-760.
18.	欧阳植松, 李棋, 李箭. 经膝后正中小切口可吸收螺钉固定治疗后交叉韧带胫骨止点撕脱骨折. 中国骨伤, 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. 桂鉴超, 王黎明, 张昊伟, 等. 跨膝关节后纵隔入路的建立及临床应用. 中华外科杂志, 2006, 44(16):1106-1110.
8. 孙金鹏, 熊依林, 雷光华. 膝关节后纵隔解剖特点及其在关节镜手术中的应用. 中国修复重建外科杂志, 2013, 27(2):233-235.
9. 戴祝, 陈志伟, 廖瑛, 等. 关节镜下滑膜全切术治疗膝关节慢性滑膜炎. 中国矫形外科杂志, 2012, 20(23):2117-2120.
10. 戴祝, 陈志伟, 廖瑛. 大腿肌萎缩对半月板成形或缝合后疗效的影响. 中国内镜杂志, 2013, 19(9):910-913.
11. 罗浩, 余家阔. 膝关节后纵隔与后交叉韧带下止点的解剖关系及临床意义. 解剖学报, 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. 陈志伟, 伍俊星, 梁先勇, 等. 关节镜下治疗内侧半月板后角联合外侧半月板前角损伤疗效. 中国修复重建外科杂志, 2014, 28(4):438-441.
17. 陆伟, 王大平, 李顶夫, 等. 全镜下后正中入路固定后交叉韧带下止点撕脱骨折的临床研究. 中华关节外科杂志(电子版), 2010, 4(6):755-760.
18. 欧阳植松, 李棋, 李箭. 经膝后正中小切口可吸收螺钉固定治疗后交叉韧带胫骨止点撕脱骨折. 中国骨伤, 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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