膝关节镜下骨关节炎与大骨节病组织形态对照分析(英文)  

Comparison of histomorphological changes between osteoarthritis and kaschin-beck disease with knee arthroscope

作　　者：凌鸣[1] 易智[1] 常彦海[1] 李建发 罗振群[1] 

机构地区：[1]陕西省人民医院骨科,陕西省西安市710068 [2]洛川县人民医院外科,陕西省洛川县727400

出　　处：《中国临床康复》2005年第30期268-269,F0003,共3页Chinese Journal of Clinical Rehabilitation

基　　金：陕西省科学技术研究发展计划项目(2001K10-G9)~~

摘　　要：背景:骨关节炎和大骨节病两者的病理改变有相似之处,但大骨节病病因不清,破坏更严重。通过对二者病理改变的对照分析,希望利用骨关节炎的治疗经验,确立一种关节镜下治疗大骨节病的有效方法。目的:通过对膝骨关节炎与大骨节病病变组织的形态进行对照,便于膝关节镜下对大骨节病的诊断和手术方法的选择。设计:病例分析。单位:陕西省人民医院骨科。对象:于1998-04/2000-09在陕西省人民医院骨科随机选取35例膝关节严重骨关节炎,需行关节镜手术的患者;2001-11在陕西省洛川县医院(疫区)随机选取31例大骨节病膝关节功能障碍的患者。方法:两组病例均采用日本OLYMPUS全套彩色电视关节镜及手术系统施行膝关节手术,术中进行录像记录,术后剪辑、拍照及对照、分析。膝关节镜手术中观察两种疾病膝关节滑膜、髌骨、股骨、胫骨及半月板的病理改变。主要观察指标:①大骨节病与骨关节炎患者膝关节滑膜损伤检查结果。②软骨损伤检查结果。③半月板损伤检查结果。结果:对66例患者的观察结果全部进行了统计、分析,无样本脱落。①大骨节病与骨关节炎滑膜损伤检查结果:损伤分级0级、1级、2级、3级,大骨节病与骨关节炎患者分别有0,3,5,23例和0,3,16,16例(P<0.05)。②软骨损伤检查结果:大骨节病软骨损伤表现为大片软骨剥离,部分脱落致骨裸露,裸露骨面凹凸不平;骨关节炎软骨损伤表现为软骨磨损,在骨裸露处可残留软骨岛,骨裸露面不光滑有时见到纤维条带附着于表面。③半月板损伤检查结果:大骨节病半月板损伤24例,应力点毛糙5例,形态为毛刺样破损19例,其中内外侧半月板均有损伤9例;骨关节炎半月板损伤16例,边缘磨损11例,破损5例。结论:大骨节病较之骨关节炎患者膝关节的软骨损伤明显严重,尽管大骨节病发展的结局也是严重的骨关节损伤,但其病理BACKGROUND： The pathological changes of osteoarthritis are similar to that of kasehin-beek disease, but the cause of the latter is still unclear, damage is more serious. From the comparison of pathology changes between them, we hope to find out an effective therapeutic method with the assistance of arthroscope basing on the experiences in osteoarthritis. OBJECTIVE： To make comparison of the histomorphological changes between osteoarthritis and kaschin-heek disease with knee arthroscope,which give clues to the diagnosis and selection of operative technique for kaschin-heek disease under arthroscope. DESIGN： Case control study. SETTING： Department of Orthopaedics, Shaanxi People＇s Hospital. PARTICIPANTS： Thirty-five patients who needed arthroscope surgery due to severer knee osteoarthritis were randomly selected from Department of Orthopaedics, Shaanxi People＇s Hospital between April 1998 and September 2000; Meanwhile 31 patients with knee joint functional obstacle caused by kasehin-heek disease （epidemic disease area） were randomly selected from Luoehuan Hospital of Shaanxi Province in November 2001. METHODS： Japanese made OLYMPUS series color television arthroscope and surgery system were used to carry out knee joint operations in all participants. During the operation, video recording, postoperative editing, photographs, comparison and analysis were conducted, in order to find out the pathological changes of the two groups in knee joint synovium, patella, fe- mur, tibia and meniscus with the assistance of arthroscope. MAIN OUTCOME MEASURES：①The knee joint synovium injury of patients with kaschin-beek disease and osteoarthritis. ②Cartilage injury. ③Meniscus damage. RESULTS： Totally 66 patients were enrolled in this study and all entered in the statistics and result analysis, without missing ①Synovium damage in Kasehin-heck disease and osteoarthritis： Injuries were graded into grade 0, 1, 2 and 3, there were 0,3,5,23 cases and 0,3,16,16 eases correspondingly in kasehin-beek diseas

关 键 词：大骨节病 骨关节炎 膝 组织 

分 类 号：R684[医药卫生—骨科学]