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临床研究  

Clinical study on the curative effects of arthroscopic denervation around patella in treatment of patellofemoral osteoarthritis with anterior knee pain and the degree of cartilage degeneration

作　　者：匡萃琳[1] 罗军[1] 刘长志[2] Kuang Cuilin;Luo Jun;Liu Changzhi(Department of Orthopedics,Ji' an Central People' s Hospital,Ji' an,Jiangxi,343000,China;Department of Orthopedics,Jishui County People' s Hospital,Jishui,Jiangxi,331600,China)

机构地区：[1]吉安市中心人民医院骨科,江西吉安343000 [2]吉水县人民医院骨科,江西吉水331600

出　　处：《当代医学》2019年第23期1-3,共3页Contemporary Medicine

基　　金：吉安市2018年指导性科技计划项目

摘　　要：目的探求髌股关节炎膝前痛患者采用膝关节镜下髌骨周围去神经化治疗对其疗效及软骨退变程度的影响。方法研究对象为本院2018年4月至2018年5月收治的86例髌股关节炎膝前痛患者,采用计算机程序生成随机数的方法将患者分为观察组和对照组,各43例。对照组行膝关节镜下清理术治疗,观察组行膝关节镜下清理术的同时采用髌骨周围去神经化治疗,对比对照组与观察组、不同软骨退变程度患者术前、术后6个月Lysholm和WOMAC评分间差异。结果术后6个月,观察组与对照组Lysholm评分较术前高,WOMAC评分较术前低,且观察组Lysholm评分(91.36±3.55)分较对照组(80.26±4.25)分高,WOMAC评分(32.61±4.60)分较对照组(47.26±5.11)分低,差异有统计学意义(P<0.05);Ⅰ~Ⅳ级患者术后6个月Lysholm评分[(90.10±3.25)分、(86.23±3.56)分、(78.51±4.01)分、(70.21±5.32)分]均较术前[(70.58±5.52)分、(62.26±5.17)分、(56.22±4.96)分、(51.34±4.27)分]高,WOMAC评分[(30.14±3.25)分、(42.01±3.24)分、(49.68±3.65)分、(67.51±3.84)分]较术前[(47.26±4.14)分、(58.02±4.33)分、(64.98±4.26)分、(73.01±4.22)分]低,差异具有统计学意义(P<0.05)。结论髌股关节炎膝前痛患者采用膝关节镜下髌骨周围去神经化治疗效果显著,可缓解临床症状,改善膝关节功能,适用于Ⅰ~Ⅳ级软骨退变患者。Objective To investigate the influence of arthroscopic denervation around patella therapy on the efficacy and degree of cartilage degeneration in patellofemoral osteoarthritis patients with anterior knee pain.Methods 86 patellofemoral osteoarthritis patients with anterior knee pain in the hospital from April 2018 to May 2018 were selected,and they were divided into observation group and control group by random number table,with 43 cases in each group.Control group was given arthroscopic debridement,while observation group was treated with arthroscopic debridement and denervation around patella therapy.The preoperative,postoperative 6 months Lysholm and WOMAC scores of control group,observation group,patients with different degree of cartilage degeneration were compared.Results After the operation for 6 months,the Lysholm scores of two groups were higher than those before the operation,the WOMAC scores of two groups were lower than those before the operation,the Lysholm score of observation group(91.36±3.55)points was higher than control group(80.26±4.25)points,and the WOMAC score of observation group(32.61±4.60)points was lower than control group(47.26±5.11)points(P<0.05);After the operation for 6 months,the Lysholm scores of degreeⅠ-Ⅵpatients[(90.10±3.25)points,(86.23±3.56)points,(78.51±4.01)points,(70.21±5.32)points]were higher than those before the operation[(70.58±5.52)points,(62.26±5.17)points,(56.22±4.96)points,(51.34±4.27)points],the WOMAC scores of degreeⅠ-Ⅵpatients[(30.14±3.25)points,(42.01±3.24)points,(49.68±3.65)points,(67.51±3.84)points]were lower than those before the operation[(47.26±4.14)points,(58.02±4.33)points,(64.98±4.26)points,(73.01±4.22)points](P<0.05).Conclusion Arthroscopic denervation around patella therapy for patellofemoral osteoarthritis patients has significant curative effects,it can relieve clinical symptoms and improve knee joint function,which is suitable for the patients with degreeⅠ-Ⅵcartilage degeneration.

关 键 词：髌股关节炎膝前痛 膝关节镜 髌骨周围去神经化 

分 类 号：R687.4[医药卫生—骨科学]