单纯关节镜清理与关节镜清理结合微骨折术治疗膝关节骨关节炎的效果观察  

Effect of arthroscopic debridement versus microfracture combined with arthroscopic debridement in the treatment of knee osteoarthritis

作　　者：范玉伟[1] 张志[1] 杨艺民[1] 袁登举 FAN Yuwei;ZHANG Zhi;YANG Yimin;YUAN Dengju(Department of Orthopedics,The People's Hospital of Guyuan 765600,China)

机构地区：[1]宁夏固原市人民医院,宁夏固原765600

出　　处：《宁夏医学杂志》2020年第8期721-723,共3页Ningxia Medical Journal

基　　金：宁夏回族自治区卫健委重点研究课题项目(2018-NW-08T)。

摘　　要：目的比较膝关节骨关节炎患者分别采用关节镜膝关节清理与膝关节清理结合微骨折术的治疗效果。方法膝关节骨关节炎患者80例,合并韧带损伤24例,合并半月板损伤37例。将患者分为关节镜清理术组40例和关节镜清理+微骨折术组40例,比较2组患者术后膝关节肿胀程度及疼痛改善情况、膝关节HSS功能评分及Tegner功能评分和术后并发症。结果关节镜清理术组与关节镜清理+微骨折术组术后Tegner评分均较术前明显增加,且膝关节清理+微骨折术较单纯膝关节清理术后Tegner评分明显增加(P<0.05)。膝关节清理术组与膝关节清理+微骨折组术后HSS功能评分均较术前明显增加,且膝关节清理+微骨折术更能够提高患者膝关节HSS功能评分(P<0.05)。关节清理术组患者随访结束时VAS评分为(2.21±0.23)分,关节清理术+微骨折术组患者随访结束时VAS评分为(1.71±0.26)分(P<0.05)。关节清理术组膝关节周径为(45.05±3.13)cm,关节清理+微骨折术组患者膝关节周径为(41.37±3.92)cm,关节清理结合微骨折技术能够减轻膝关节肿胀情况,延缓膝关节炎的发展(P<0.05)。关节清理术组与关节清理+微骨折术组各有1例发生肌间静脉血栓。结论膝关节镜下清理结合微骨折术治疗膝关节骨关节炎患者,术后可以获得良好的手术效果,能使膝关节炎症状减轻,并促进患者膝关节功能恢复,但还需要进一步临床研究证实。Objective To compare the effect of arthroscopic debridement versus microfracture combined with arthroscopic debridement in the treatment of knee osteoarthritis.Methods 80 patients with knee osteoarthritis,including 24 patients with ligament injury and 37 patients with meniscus injury.The patients were divided into arthroscopic debridement group(n=40)and microfracture combined with arthroscopic debridement group(n=40).The postoperative knee swelling,pain improvement,HSS and Tegner function scores and postoperative complications were compared between the two groups.Results The postoperative Tegner score of the arthroscopic debridement group and microfracture combined with arthroscopic debridement group were significantly higher than those before operation,and the Tegner score of microfracture combined with arthroscopic debridement was significantly higher than that of simple knee debridement(P<0.05).The postoperative HSS functional score of the arthroscopic debridement group and the microfracture combined with arthroscopic debridement group were significantly increased compared with the preoperative score,and the microfracture combined with arthroscopic debridement was more able to improve the HSS functional score(P<0.05).The VAS score at the end of follow-up was(2.21±0.23)points for patients in the arthroscopic debridement group,and(1.71±0.26)points for patients in the microfracture combined with arthroscopic debridement group(P<0.05).The knee circumference diameter of the arthroscopic debridement group was(45.05±3.13)cm,and that of the microfracture combined with arthroscopic debridement group was(41.37±3.92)cm(P<0.05).The microfracture combined with arthroscopic debridement technology could reduce knee swelling and delay the development of knee arthritis(P<0.05).There was one case of intermuscular vein thrombosis in the two groups respectively.Conclusion The arthroscopic debridement combined with microfracture in the treatment of patients with knee osteoarthritis can obtain a good surgical effect and allevia

关 键 词：膝关节炎 关节镜 微骨折 

分 类 号：R684.3[医药卫生—骨科学]