大骨节病膝关节镜下清理术后远期疗效评价  

Evaluation of long term effects of arthroscopic knee debridement and reconstructing for treating osteoarthritis in patients with Kaschin-Beck disease

作　　者：凌鸣[1] 黄向辉[1] 易智[1] 常彦海[1] 刘军[1] 祁洁[1] 田昕[1] 

机构地区：[1]陕西省人民医院骨科,西安710068

出　　处：《中国地方病学杂志》2010年第5期559-561,共3页Chinese Jouranl of Endemiology

基　　金：陕西省科技攻关项目（2001K10-G9）

摘　　要：目的 评价膝关节镜下关节清理修复手术治疗大骨节病膝关节骨性关节炎的远期疗效.方法 对31例行膝关节镜下关节清理术的大骨节病患者进行术后6年随访,记录疼痛指数、症状改善自我评价、关节活动度、行走距离和30°、60°单腿站立试验等指标值,与术前资料进行对比分析.结果 6年后共随访24例.术后6年患者疼痛指数（3.38±2.87）与术前（6.88±1.45）比较显著减小（t=5.30,P＜0.05）.患者对症状改善的主观自我评价显效率为70.83%（17/24）,有效率为100%（24/24）.术后6年30°、60°单腿站立试验,可站立例数（21、18例）明显多于术前（14、11例）,二者比较差异有统计学意义（x2值分别为5.17、4.27,P均＜0.05）.术后6年患者行走距离（＜1、1～5、＞5 km分别为3、11、10例）与术前（＜1、1～5、＞5 km分别为12、9、3例）比较明显改善（U=2.88,P＜0.05）.术后6年膝关节活动度[（132.25±14.52）°]与术前[（131.58±14.68）°]比较,差异无统计学意义（t=0.16,P＞0.05）.结论 膝关节镜下关节清理修复手术治疗大骨节病膝关节骨性关节炎能够显著减少疼痛,改善功能及行走距离,具有较稳定的远期满意疗效.Objective To observe the long term effects of arthroscopic knee debridement and reconstructing operation for treating osteoarthritis in patients with Kaschin-Beck disease. Methods Thirty-one cases of patients with Kaschin-Beck disease were followed for 6 years after operation of articular clearing by arthroscope. Index of pain, symptoms of self-evaluation, range of motion, walking distance, standing test by affected leg when bending at 30° or 60° were recorded and compared with the preoperative results. Results Twenty-four cases were followed up for 6 years. Six years after operation the pain index（3.38 ± 2.87） was dramatically decreased compared to that before operation （6.88 ± 1.45, t = 5.30, P 〈 0.05）. Patients symptoms markedly improved by subjective self-evaluation was 70.83% （17/24）, the effective rate was 100% （24/24）. The number of cases that could stand up when leg bending at 30° or 60° were 21,18 cases, respectively, compared with that of preoperative of 14, 11 cases, respectively, the difference was statistically significant（x2 = 5.17,4.27, all P 〈 0.05）. Six years after operation the walking distance（3 cases 〈 1 km, 11 cases 1 - 5 km and 10 cases 〉 5 km） were greatly improved compared to the results before operation （12 cases 〈 1 km, 9 cases 1 - 5 km and 3 cases 〉 5 km, U = 2.88, P 〈0.05）. Six years after operation the knee activity[（132.25 ± 14.52）°] remained at the same level, compared with that of preoperative [（131 .58 ± 14.68） °], the difference was not statistically significant （t = 0.16, P 〉 0.05） .Conclusions The method of arthroscopic joint debridement to cure Kaschin-Beck disease knee osteoarthritis can significantly reduce pain, improve function and walking distance, with more stable long-term satisfactory outcome.

关 键 词：大骨节病 关节镜 治疗效果 随访研究 

分 类 号：R686[医药卫生—骨科学]