关节镜微骨折术治疗老年膝关节软骨损伤的疗效分析  

Clinical efficacy and influence factors of micro fracture under arthroscope on treatment of knee cartilage injury of aged people

作　　者：张利强 张绍伟 廖涛 

机构地区：[1]重庆市璧山区人民医院骨科,重庆402700

出　　处：《西部医学》2016年第8期1122-1124,1129,共4页Medical Journal of West China

基　　金：国家重点基础研究发展规划项目(G1999054204)

摘　　要：目的探讨关节镜下微骨折术治疗老年膝关节软骨损伤的治疗效果，并对其影响因素进行分析。方法选取2014年1月-2015年12月在我院接受关节镜下微骨折术治疗膝关节软骨损伤的老年患者113例为研究对象。治疗前后对患者Tegner运动功能和HSS膝关节功能进行评估。根据临床治疗的效果将患者分为改善组和未改善组，对影响两组治疗效果的因素进行单因素和多因素分析。结果113例患者，显效53例，有效33例，总有效率76．11％（86／113）。治疗后，患者Tegner运动功能评分（t=30．954，P〈0．05）和HSS膝关节功能评分（t=26．582，P〈0．05）均较治疗前显著升高。多因素分析结果显示、年龄、病因、病程、软骨缺损面积、软骨损伤程度、半月板损伤、术后并发症是影响治疗效果的独立危险因素（P〈0．05）。结论关节镜下微骨折术治疗可明显改善老年膝关节损伤患者的膝关节功能和运动功能，但影响手术治疗效果的因素较多，临床应制定相应的防治措施。Objective To investigate the clinical efficacy and influence factors of micro fracture under arthroscope on treatment of knee cartilage injury of aged people. Methods 113 aged people with knee cartilage injury treated with micro fracture under arthroscope in our hospital from January 2014 to December 2015 were selected as research objects. Tegner motor function and HSS knee function of patients were evaluated before and after treatment. All of the patients were divided into the improvement group and non-improvement group, according to the clinical efficacy. The factors influencing the treatment effect of the two groups were analyzed by single factor and multi factor analysis. Results In 113 cases, 53 cases were markedly effective and 33 cases were effective. The total effective rate was 76.11%（86/113）. After treatment, Tegner motor function score （t=30. 954, P（0.05） and HSS knee function score （t=26. 582, P〈0.05） of patients were significantly higher than before treatment. Multivariate analysis showed that age, etiology, course of disease, cartilage defect area, cartilage damage degree, meniscus injury, postoperative complications were the independent risk factors affecting the treatment effect （P〈0.05）. Conclusion Arthroscopic micro fracture surgery can significantly improve the knee function and motor function of aged patients with knee cartilage injury. There are many factors that affect the clinical efficacy and the corresponding preventive measures should be established.

关 键 词：关节镜 微骨折术 膝关节 软骨损伤 

分 类 号：R684[医药卫生—骨科学]