关节镜下有限清理术结合富血小板血浆治疗膝骨关节炎的临床观察  

Clinical Observation of Limited Debridement under Arthroscopy Combined with Platelet-Rich Plasma on the Treatment of Knee Osteoarthritis

作　　者：金军[1,2] 钟传棋 杨功旭[1,2] 霍雄涛[1,2] 吴斌[1,2] JIN Jun;ZHONG Chuanqi;YANG Gongxu;HUO Xiongtao;WU Bin(Department of Orthopedics,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430061,China;Hubei Province Academy of Traditional Chinese Medicine,Wuhan 430074,China.)

机构地区：[1]湖北省中医院骨伤科,武汉430061 [2]湖北省中医药研究院

出　　处：《中国中医骨伤科杂志》2023年第3期55-58,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：湖北省自然科学基金指导项目(2017CFC836);湖北省中医院“五专建设”项目(2018)。

摘　　要：目的:探讨关节镜下有限清理术结合富血小板血浆(Platelet-Rich Plasma,PRP)注射治疗膝骨关节炎的临床疗效。方法:选择2019年1月至2020年6月接受关节镜手术的膝骨关节炎患者96例,按照治疗方法不同进行分组,单纯关节镜下有限清理患者为对照组,在对照组基础上加用富血小板血浆注射为观察组,以治疗前及治疗后1,3,6,12个月为观察时间节点,对两组患者一般情况、疼痛视觉模拟量表(VAS)评分、西安大略和麦克马斯特大学(WOMAC)骨性关节炎指数、Lysholm膝关节评分、美国特种外科医院(HSS)膝关节功能评分进行对比分析。结果:两组患者一般资料差异无统计学意义(P>0.05),术前VAS评分、WOMAC指数、Lysholm评分和HSS评分组间比较差异无统计学意义(P>0.05);两组VAS评分和WOMAC指数在术后各观察节点上与治疗前相比明显偏低,差异有统计学意义(P<0.05);两组Lysholm评分和HSS评分在术后各观察节点上与治疗前相比明显偏高,差异有统计学意义(P<0.05)。治疗后1个月和3个月两组组间比较,上述四项差异无统计学意义(P>0.05);治疗后6个月和12个月观察组与治疗组比较,VAS评分和WOMAC指数偏低,差异有统计学意义(P<0.05);Lysholm评分和HSS评分偏高,差异有统计学意义(P<0.05)。结论:关节镜下有限清理术结合富血小板血浆治疗膝骨关节炎临床疗效良好,能缓解疼痛,改善关节功能,中期临床疗效优于单纯关节镜清理治疗。Objective:To explore the clinical efficacy of limited debridement under arthroscopy combined with platelet-rich plasma injection on the treatment of knee joints.Methods:96 patients with knee osteoarthritis who underwent arthroscopic surgery from January 2019 to June 2020 were analyzed.They were grouped according to different treatment methods.Patients with limited clearing under arthroscopy were classifed as the control group.On the basis of the group,platelet-rich plasma(PRP)injection was added for the observation group.Before treatment,1,3,6,and 12 months after treatment were the observation time.The general condition,visual analogue scale(VAS)score,The Western Ontario and McMaster Universities(WOMAC)osteoarthritis index,Lysholm knee score and Hospital for Special Surgery(HSS)knee function score of the two groups were documented and compared.Results:There was no difference in general information between the two groups of patients.There was no statistically significant difference between the groups in the preoperative VAS score,WOMAC index,Lysholm score and HSS score(P>0.05).The VAS score and WOMAC index of the two groups were significantly lower at the observation points after operation than before treatment(P<0.05).The Lysholm score and HSS score of the two groups were significantly higher at the observation points after treatment than before treatment(P<0.05).The above four items were compared between the two groups in the 1,3 months after treatment.The difference was not statistically significant(P>0.05).Compared with the treatment group,the VAS score and WOMAC index at 6 and 12 months after treatment were lower in the observation group(P<0.05),and the Lysholm score and HSS score were higher(P<0.05).Conclusion:Arthroscopic limited debridement combined with PRP has a good clinical efficacy on the treatment of knee osteoarthritis,which can relieve pain and improve joint function.The mid-term clinical efficacy is better than pure arthroscopic debridement.

关 键 词：膝骨关节炎 关节镜 有限清理 富血小板血浆 

分 类 号：R684.3[医药卫生—骨科学]