关节镜下治疗膝关节骨关节炎的疗效随访  

Clinical efficacy of arthroscopic debridement for osteoarthritis of the knee

作　　者：周凯[1] 陈凯[1] 王靖[1] 李敬[1] 陈成帷[1] 郎俊哲[1] 

机构地区：[1]浙江省温州医科大学附属第一医院骨科,325000

出　　处：《中华全科医学》2015年第10期1573-1575,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2014KYB315)

摘　　要：目的 对关节镜手术治疗膝关节骨关节炎的疗效进行随访.方法 分析127例因膝关节骨关节炎于温州医科大学附属第一医院行关节镜手术治疗的患者127例临床资料及随访资料,纳入标准如下：①年龄大于50岁;②临床表现及影像学表现支持骨关节炎诊断;③Ahlb（a）ck分级为Ⅰ-Ⅲ级.治疗前后采用Lysholm及国际膝关节评分委员会（International Knee Documenting Committee,IKDC）评分标准评价主观症状.结果 最后一次随访时Lysholm、IKDC膝关节功能评分均优于手术前,差异有统计学意义,Lysholm评分及IKDC评分：最后一次随访时及手术前评分分别为87.9±14.0、79.1±13.5以及54.6±12.3、54.9±9.7,差异有统计学意义（P均为0.01）.76％的患者术后膝关节功能为优-良.50～70岁患者术后评分高于术前,差异有统计学意义,Lysholm评分及IKDC评分：最后一次随访时及手术前评分分别为81.3±13.9、80.2±11.9及59.0±10.1、60.6±2.4,差异有统计学意义（P均为0.02）.70岁以上患者术后与术前评分差异无统计学意义,Lysholm评分及IKDC评分：74.5±9.2、67.6±8.6及55.8±9.6、56.3±8.5（P均为0.09）.结论 中期随访研究表明关节镜清理术对70岁以下的膝关节骨关节炎可取得较好的疗效.Objective To discuss the therapeutic efficacy of arthroscopic debridement in the treatment of osteoarthritis （OA） of the knee. Methods The clinical data and follow-up data of 127 patients with OA of knee undergoing arthroscopic debridement in our hospital were reviewed retrospectively. Inclusion criteria： age was 50years or over, clinical futures and imaging diagnosis showed knee OA with an Ahlbaick Ⅰ - Ⅲ classification. The Lysholm and IKDC scores were assessed before and after surgery. Results The postoperative average scores were higher than preoperative average scores （ Lysholm ：87.9± 14.0 vs. 54.6 ±12.3,P = 0.01 ; IKDC ：79.1 ±13.5 vs. 54.9 ± 9.7,P = 0.02）. Good or excellent resuits were observed in 76% of the cases according to the Lysholm and IKDC scores. The group of patients between 50 and 70 years of age had better results after the surgery （ Lysholm ： 81.3 ± 13.9 vs 59.0 ± 10.1, P = 0.02 ; IKDC ： 80.2 ±11.9 vs. 60.6 ±2.4 ,P =0.02）. However,the functional results were not significantly improved in patients over 70 years（ Ly- sholm：74.5±9.2vs. 55.8＋9.6,P=0.09;IKDC：67.6±8.6vs. 56.3±8.5,P=0.09）.Conclusion The patients under 70 years old with knee OA will get good-to-excellent symptomatic results after the rthroscopic debridement.

关 键 词：疗效随访 膝关节骨关节炎 关节镜清理术 

分 类 号：R684.3[医药卫生—骨科学] R687.4[医药卫生—外科学]