关节镜下清理术治疗膝骨关节炎的中期疗效随访  

Study on midterm follow-up results of arthroscopic debridement for knee osteoarthritis

作　　者：孙钢[1] 尹天[1] 张淳[1] 赵铁军[1] 顾力军[1] 张洪美[1] 

机构地区：[1]中国中医科学院望京医院,北京100102

出　　处：《中国骨伤》2010年第12期903-905,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:评价关节镜下清理术治疗膝骨关节炎的中期疗效。方法:对2000-2004年采用关节镜下清理术治疗的56例(56膝)膝骨关节炎病例进行了回顾性研究。其中,男15例,女41例;年龄39～76岁,平均(55.23±10.26)岁;病程1～25个月,平均5.75个月。症状主要为膝关节疼痛、肿胀和功能受限。Kellgren-Lawrence X线分级:Ⅰ级17例,Ⅱ级39例。术后进行康复锻炼和健康教育。治疗前后采用膝关节Lysholm评分进行疗效评价。结果:全部患者获随访,时间5年以上,3例分别于术后5.5、7.8和8.3年行膝关节置换术,其余患者膝关节Lysholm评分由术前的平均(42.40±6.78)分增加到术后的(75.53±8.23)分。治疗后评分较治疗前提高,t=-22.62,P<0.01。结论:合理选择适应证,采用有限镜下清理,配合健康教育、系统的康复锻炼及使用软骨保护剂,关节镜下清理术治疗膝骨关节炎能够获得良好的中期疗效。Objective： To evaluate the effect of arthroscopic debridement for knee osteoarthritis. Methods： The medical records of 56 patients （56 knees） who underwent arthroscopie dehridement procedures for knee osteoarthritis from 2000 to 2004 were reviewed. Among the patients, 15 patients were male and 41 patients were female,ranged in age from 39 to 76 years,with an average of （55.23±10.26） years. The duration of the disease ranged from 1 to 25 months, with an average of 5.75 months. The chief symptoms were pain, swelling and dysfunction of the knees. According to Kellgren-Lawrence classification grade, 17 patients were grade Ⅰ , 39 patients were grade Ⅱ. Lysholm score was used to evaluate the postoperative effects, and the statistics analysis was carried out with SPSS 13.0. Results：All the patients were followed up more than 5 years. Three patients underwent total knee replacement respectively at 5.5,7.8 and 8.3 years after the arthroscopic debridement, the average Lysholm score of other 53 patients increased from（42.40±6.78 ） preoperatively to（75.53±8.23 ） postoperatively. There were significant difference between preoperative score and postoperative score （t=-22.62,P〈0.01）. Conclusion： The good midterm follow-up results of arthroscopic debridement for knee osteoarthritis are related to the appropriate indications selections, limited debridement, good patient education, systemic rehabilitation and chondroprotective agents.

关 键 词：骨关节炎 膝 关节镜检查 康复 

分 类 号：R684.305[医药卫生—骨科学]