关节镜治疗膝关节骨性关节炎78例临床分析  

Clinical analysis of arthroscopic treatment of knee osteoarthritis in 78 cases

作　　者：靳丹[1] 余进伟[1] 白伟[1] 赵意华[1] 

机构地区：[1]焦作市第二人民医院,河南焦作454000

出　　处：《腹腔镜外科杂志》2013年第9期711-713,共3页Journal of Laparoscopic Surgery

摘　　要：目的:总结关节镜下行关节清理术治疗膝关节骨性关节炎的临床效果与应用价值。方法:回顾分析2010年4月至2013年2月局麻下为78例膝关节骨性关节炎患者经关节镜行关节清理术的临床资料,其中男29例,女49例;平均(61±10)岁;关节镜下关节清理术包括刨削清理突入髌股关节、胫股关节及髁间窝内增生肥厚的炎性滑膜组织,修整老化退变、破损的半月板,解除交锁因素,清除剥脱的软骨碎屑,修平缺损的软骨边缘,松解关节腔内的炎性索带及粘连带,切断滑膜皱襞,清理髌下脂肪,去除关节腔内的游离体。术后随访患侧膝关节的功能状态,患者日常活动能力及对手术的满意度。结果:手术时间平均(50±10)min,术中出血量极少。术后平均随访(15±9)个月,78例患者中优48例,良23例,差7例,优良率达91%。结论:局麻下经关节镜行关节清理术治疗膝关节骨性关节炎可有效解除临床症状,改善功能,延缓病变发展,严格把握手术适应证可取得满意疗效。Objective：To observe the clinical effectiveness of arthroscopic joint debridement for treating knee osteoarthritis. Methods ：The clinical data of 78 patients with knee osteoarthritis who received arthroscopic joint debridement under local anesthesia from Apr. 2010 to Feb. 2013 were retrospectively analyzed,including 29 males and 49 females. They were in the age of （61 ± 10）. Fi- nite joint arthroscopic debridement involved the following steps：planing and clearing inflammatory synovial tissue which were hyperpla- sia in patellofemoral, tibiofemoral joint and the intercondylar fossa;repairing aging degenerated, damaged meniscus, removing interloc- king factors;clearing exfoliated cartilage debris, repairing defective cartilage edge;releasing inflammatory straps and adhesions in articu- lar cavity, cutting synovial plica, cleaning infrapatellar fat ; removing intra-articular loose bodies. All patients were followed up. Follow-up data included patients＂ knee functional status, daily activities and their satisfaction with surgery. Results：The operative time was （50 ± 10） min, blood loss was little. All patients were followed up for （15 ± 9） months. In the 78 patients,48 knees were excellent,23 knees were good, and 7 were bad;excellent and good rate was 91%. Conclusions：It is a reliable method to treat knee osteoarthritis by arthros- copy under local anesthesia ,which can effectively remove symptoms, improve joint function and slow down disease development. Satis- factory effect could be obtained as long as surgeons can strictly select indications.

关 键 词：关节镜 骨关节炎 膝 治疗结果 

分 类 号：R684.3[医药卫生—骨科学]