关节镜下关节有限清理术联合玻璃酸钠治疗膝骨关节炎  

Arthroscopic Limited Debridement Combined with Sodium Hyaluronate for Knee Osteoarthritis

作　　者：仲文军 王恒[1] 阮子平 杨劲松[1] 鲁成[1] 李斌[1] 侯德胜[1] 刘磊[1] 

机构地区：[1]安徽省滁州市第二人民医院骨科,滁州239001

出　　处：《中国微创外科杂志》2015年第4期341-343,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨关节镜下关节有限清理术治疗早中期膝骨关节炎（knee osteoarthritis,KOA）的疗效。方法 2004年4月~2013年10月,对45例早中期KOA在关节镜下进行刨削清理增生肥厚的炎性滑膜组织,修平退变剥脱的软骨创面,游离体摘除,去除影响关节活动的骨赘,半月板修整或成形等,术后关节腔内注入玻璃酸钠4 ml。治疗前后采用膝关节Lysholm评分进行疗效评估。结果关节镜手术时间（从关节镜进入膝关节到开始缝合切口）为（55±15）min。术后住院时间4~10 d,平均6 d。术后均无关节感染、血管神经损伤、深静脉栓塞等并发症的发生。45例随访时间3~26个月,平均12个月,Lysholm评分由术前（45.5±6.3）分提高到（78.7±8.3）分,手术前后有统计学差异（t=9.841,P=0.005）。结论关节镜下关节有限清理术联合玻璃酸钠具有创伤小,并发症少,有效缓解KOA症状,有效改善关节功能的优点,是治疗早中期KOA的有效方法。Objective To evaluate the clinical outcomes of arthroscopic limited debridement combined with sodium hyaluronate for early period knee osteoarthritis（KOA）.Methods From April 2004 to October 2013,45 patients with KOA were treated with arthroscopic debridement.The debridement procedures included removal of hyperplastic synovial membrane,trimming the surface of degenerated articular cartilage,taking out loose bodies,removing the osteophytes which preventing the movement of the knee,menissectomy for torn meniscus,and injecting sodium hyaluronate（4 ml） into articular cavity.The Lysholm score was used to evaluate the results before and after arthroscopy.Results The average arthroscopic time（from arthroscope entering the knee to suturing the portal incision） was（55 ± 15） min.The length of hospital stay after operation was 4-10 d,with an average of 6 d.No joint infection,nerve and vessel injury,or deep venous thrombosis were found after operation.All the 45 patients were followed up for3-26 months,with an average of 12 months.The Lysholm scores improved from preoperative（45.5 ± 6.3） points to postoperative（78.7 ± 8.3） points,with statistical difference（t = 9.841,P = 0.005）.Conclusions Arthroscopic limited debridment combined with sodium hyaluronate has advantages of minimal invasion,fewer complications,better curative effects.It is effective in relieving KOA symptoms and improving joint functions in appropriately selected patients,being an effective therapy for early period KOA.

关 键 词：膝骨关节炎 关节镜 

分 类 号：R687.4[医药卫生—骨科学]