膝关节镜下髌骨周围去神经化治疗髌股关节炎膝前痛的治疗效果及与软骨退变程度的相关性  

Clinical Effect of Arthroscopic Circumpatellar Denervation in Anterior Knee Pain of Patellofemoral Osteoarthritis and its Correlation with Cartilage Degeneration

作　　者：刘明东[1] 刘国太[1] 佟杰[1] 

机构地区：[1]绍兴文理学院附属医院骨科,312000

出　　处：《医学研究杂志》2017年第4期157-160,共4页Journal of Medical Research

摘　　要：目的探讨膝关节镜下髌骨周围去神经化治疗髌股关节炎膝前痛的临床治疗效果,及其与软骨退变程度的相关性。方法将104例髌股关节炎膝前痛患者随机分为联合组和对照组,各52例。对照组采用膝关节镜下关节清理术,联合组在此基础上联合髌骨周围去神经化治疗,术后随访6个月。比较两组患者WOMAC评分、膝关节功能恢复情况,并分析不同软骨退变程度的WOMAC评分变化。结果术后6个月,联合组疼痛、晨僵及关节功能WOMAC评分均显著低于对照组(P<0.05);术后6个月,两组步行距离评分、活动范围评分显著升高,但联合组显著高于对照组(P<0.05);与术前比较,Ⅰ~Ⅲ级患者术后6个月WOMAC总评分明显降低(P<0.05),而Ⅳ级患者术前、术后6个月WOMAC总评分差异无统计学意义(P>0.05)。结论膝关节镜下关节清理联合髌骨周围去神经化治疗髌骨关节炎膝前痛,可有效缓解疼痛症状,促进膝关节功能的恢复,尤其适用于Ⅰ~Ⅲ级软骨退变患者。Objective To explore clinical effect of arthroseopic eircumpatellar denervation in anterior knee pain of patellofemoral osteoarthritis and its correlation with eartilage degeneration. Methods Totally 104 patients with anterior knee pain of patellofemoral osteoarthritis were randomly divided into two groups. Patients in control group（n = 52） were treated with arthroscopie debridement, and those in combined group（n = 52） were treated with arthroseopic debridement plus circumpatellar denervation. All the patients were followed - up for 6 months. The WOMAC scores, knee funetion recovery were compared between two groups, and the changes of WOMAC seore among different degrees of cartilage degeneration were analyzed. Results The WOMAC score of pain, morning stiffness and joint function were significantly improved in combined group than those in control group at 6 months after surgery（ P 〈 0.05）. At 6 months after surgery, the score of range of activity and walking distance in both groups were all increased, and eombined group had more remarkable increase than that of control group（P 〈 0.05）. Compared with before surgery, the total WOMAC score in patients with grade Ⅰ-Ⅲ at 6 months after surgery significantly decreased （ P 〈 0.05 ） , while there was no significant difference in patients with grade Ⅳ level between before surgery and 6 months after surgery （P 〉 0.05 ）. Conclusion Arthroscopic debridement plus circumpatellar denervation for anterior knee pain of patellofemoral osteoarthritis ean effectively relieve pain symptom, promote the recovery of knee joint function, espeeially suitable for patients with cartilage degeneration of Ⅰ - Ⅲ.

关 键 词：髌股关节炎 膝前痛 膝关节镜 去神经化 软骨退变 

分 类 号：R684.3[医药卫生—骨科学]