膝关节镜下关节清理联合髌周去神经化治疗膝前痛  

Arthroscopic debridement combined with peri-patellar denervation for anterior knee pain

作　　者：王兵[1] 汤志宏 孙晓庚 唐孟军 王廷江 WANG Bing;TANG Zhi-hong;SUN Xiao-geng;TANG Meng-jun;WANG Ting-jiang(Department of Orthopaedics,The 967h Hospital of PLA,Dalian 116100,China;Dalian Medical Universityy Dalian 116100,China)

机构地区：[1]中国人民解放军联勤保障部队第九六七医院,大连116100 [2]大连医科大学,116100

出　　处：《中国矫形外科杂志》2020年第8期702-706,共5页Orthopedic Journal of China

摘　　要：[目的]探讨膝关节镜下关节清理联合髌周去神经化治疗膝前痛的临床治疗效果。[方法] 2017年9月~2019年3月单侧膝前痛男性患者50例纳入本研究,采用随机抽签法将患者分为两组,每组25例。清理组采用单纯膝关节镜下关节清理术,联合组在清理术的基础上联合射频髌周去神经化治疗,比较两组患者临床效果。[结果]两组患者均顺利手术,两组患者在手术时间、术中灌注量和住院时间的差异均无统计学意义(P>0.05)。两组患者术后切口均一期愈合,无切口感染、下肢血栓等并发症。随访8~11个月,平均(9.06±0.89)个月。两组患者随时间推移,VAS评分均显著减少,而Lysholm和Kujala评分均显著增加,不同时间点间差异有统计学意义(P<0.05)。术前一周两组VAS、Lysholm和Kujala评分的差异均无统计学意义(P>0.05),但术后8个月时,联合组的VAS评分显著低于清理组,而联合组的Lysholm和Kujala评分均显著高于清理组,差异均有统计学意义(P<0.05)。MRI显示两组患者关节软骨退变差异无统计学意义(P>0.05)。[结论]相对于单纯关节清理,膝关节镜下清理术联合髌周去神经化治疗膝前痛能显著提高疗效。[Objective] To explore the clinical outcomes of arthroscopic debridement combined with peri-patellar denervation for treatment of anterior knee pain. [Methods] From September 2017 to March 2019, 50 patients with unilateral anterior knee pain were enrolled into this study, and divided into two groups by using random drawing with 25 patients in each group. Of them, the patients in the debridement group received arthroscopic debridement only, whereas those in the combined group had arthroscopic debridement combined with peri-patellar denervation with radiofrequency ablation performed. The clinical outcomes were compared between the two groups. [Results] The patients in both groups had surgical procedures performed successfully, with on statistically significant differences in operation time, intraoperative irrigation volume and hospital stay between two groups(P>0.05). All the patients got primary incision healing, without complications, such as infection and thrombosis of the lower extremity. The follow-up period lasted for 8~11 months with an average of(9.06±0.89) months. As time went, the VAS score significantly decreased, while the Lysholm and Kujala scores significantly increased in both groups, with statistical differences among time points(P<0.05). Although there were on statistically significant differences between the two groups regarding VAS, Lysholm and Kujala scores before operation, the combined group was marked significantly lower VAS score,whereas significantly higher Lysholm and Kujala scores than the debridement group at 8 months postoperatively(P<0.05). In addition, there was no a statistically significant difference in extent of cartilage degeneration revealed by MRI between two groups(P>0.05). [Conclusion] As opposed to just cleaning the joint, this arthroscopic debridement combined with peri-patellar denervation does improve the clinical outcomes for anterior knee pain.

关 键 词：膝前痛 关节镜清理术 去神经化 

分 类 号：R687.4[医药卫生—骨科学]