关节镜清理术联合透明质酸钠改善膝骨性关节炎患者骨代谢及膝功能的临床研究  

Clinical study of improvement of bone metabolism and knee function in patients with knee osteoarthritis by arthroscopic debridement combined with sodium hyaluronate

作　　者：杜中华 西立峰[1] 张华 DU Zhonghua;XI Lifeng;ZHANG Hua(Department of Orthopedics,Yellow River Sanmenxia Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]黄河三门峡医院骨科,河南472000

出　　处：《中国骨科临床与基础研究杂志》2024年第5期353-357,共5页Chinese Journal of Orthopaedic Clinical and Basic Research

摘　　要：目的探讨关节镜清理术联合透明质酸钠对膝骨性关节炎(KOA)患者骨代谢及膝功能的改善作用。方法选取2021年10月至2023年8月黄河三门峡医院收治的101例KOA患者,根据随机数字表法将患者分为联合组(n=51)和对照组(n=50),对照组接受关节镜清理术治疗,联合组接受关节镜清理术联合透明质酸钠关节腔内注射治疗,比较两组术后6个月膝关节功能,评估术前及术后1、3、6个月血清Ⅱ型胶原羧基端肽(CTX-Ⅱ)、软骨寡聚基质蛋白(COMP)、骨保护素(OPG)等骨代谢指标以及关节液内C-反应蛋白(CRP)、白细胞介素-6(IL-6)、细胞间黏附因子-1(ICAM-1)含量变化,记录随访期间并发症发生情况。结果联合组术后6个月膝关节功能优良率高于对照组(P<0.05)。两组患者术后不同时相点血清CTX-Ⅱ、COMP含量均较术前降低,其中联合组术后1、3、6个月血清CTX-Ⅱ及术后3、6个月血清COMP含量均低于对照组;与术前比较,两组术后不同时相点血清OPG含量均升高,且联合组更高(P<0.05)。两组术后不同时相点关节液内CRP、IL-6、ICAM-1含量均较术前降低,且联合组更低(P<0.05)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论关节镜清理术联合透明质酸钠治疗KOA有助于改善患者骨代谢状态,减轻炎症反应,促进膝关节功能恢复,安全性良好。Objective To explore the effect of arthroscopic debridement combined with sodium hyaluronate on bone metabolism and knee function in patients with knee osteoarthritis(KOA).Methods A total of 101 patients with KOA admitted to Yellow River Sanmenxia Hospital from October 2021 to August 2023 were divided into the combined group(n=51)and the control group(n=50)using random number table method.Patients in the control group received arthroscopic debridement,while patients in the combined group received arthroscopic debridement combined with intraarticular injection of sodium hyaluronate.The knee joint function of the two groups was compared at 6 months after operation.Bone metabolism indexes such as serum carboxyl-terminal telopeptide of typeⅡcollagen(CTX-Ⅱ),cartilage oligomeric matrix protein(COMP)and osteoprotegerin(OPG),as well as C-reactive protein(CRP),interleukin(IL)-6 and intercellular adhesion molecule(ICAM)-1 in joint fluid were evaluated before operation and at 1,3 and 6 months after operation.The complications were recorded during the follow-up period.Results The excellent and good rate of knee joint function of the combined group was higher than that of the control group at 6 months postoperatively(P<0.05).The levels of serum CTX-Ⅱand COMP of the two groups at all time points after operation were lower than those before operation(P<0.05).In combined group,serum CTX-Ⅱlevels at 1,3,6 months postoperatively and COMP levels at 3 and 6 months postoperatively were lower than those postoperative ones in the control group.Serum OPG amount in both groups was increased at all time points after operation when compared with those before operation,and the combined group was higher than the control group(P<0.05).The levels of CRP,IL-6 and ICAM-1 in joint fluid of the two groups were decreased at all time points after operation,and the combined group was lower than the control group(P<0.05).There was no statistical difference in total incidence of postoperative complications between the two groups(P>0.05).Conclusi

关 键 词：膝骨性关节炎 关节镜检查 关节清理术 透明质酸 骨代谢 

分 类 号：R684.3[医药卫生—骨科学] R443.7[医药卫生—外科学]