摘要
目的探讨关节镜下关节清理扩创微骨折术治疗膝骨关节炎(osteoarthritis of knee,KOA)的临床疗效。方法 KOA病人180例,根据治疗方法的不同分为对照组与观察组,对照组88例,采用单纯关节镜下关节清理术;观察组92例,采用关节镜下关节清理扩创微骨折术治疗。比较两组病人膝关节功能、疼痛、炎性因子及临床疗效。结果两组病人术前Lysholm评分比较差异无统计学意义(P>0.05),术后1、6个月两组病人Lysholm评分均较术前升高,其中观察组病人术后1个月Lysholm评分为(70.59±3.29),术后6个月为(84.57±10.22),对照组分别为(65.14±3.24)、(78.54±10.24),两组比较差异均有统计学意义(P<0.05)。两组病人术前视觉模拟疼痛评分(visual analog scale,VAS)比较差异无统计学意义(P>0.05),术后1、6个月两组病人VAS评分均较术前降低,其中观察组病人术后1个月VAS评分为(21.88±5.54),术后6个月为(12.57±8.55),对照组分别为(30.19±5.59)、(24.50±8.59),两组比较差异均有统计学意义(P<0.05)。术前两组病人C反应蛋白(CRP)、白细胞介素(IL)-6水平比较差异无统计学意义(P>0.05),术后两组病人CRP水平较治疗前升高,IL-6水平降低,其中观察组病人术后CRP为(13.69±6.18)mg/L、IL-6为(20.31±10.42)ng/L,对照组分别为(23.51±6.71)mg/L、(26.51±10.41)ng/L,两组比较差异均有统计学意义(P<0.05)。观察组病人临床总有效率为97.83%,对照组为89.78%,两组比较差异有统计学意义(P<0.05)。结论关节镜下关节清理扩创微骨折术治疗膝骨关节炎临床疗效较单纯关节镜下关节清理术效果优佳,联合治疗能显著提高病人膝关节功能,减少疼痛。
Objective To investigate the effect of arthroscopic debridement combined with microfracture on joint function in the treatment of knee osteoarthritis(KOA).Methods The clinical data of 180 cases of KOA treated were retrospectively analyzed,and patients were divided into two groups according to different treatment methods.88 patients in the control group received arthroscopic joint debridement,while 92 patients in observation group received arthroscopic debridement combined with microfracture.Then the knee joint function,pain degree,inflammatory factor levels,and clinical efficacy were compared between the two groups.Results The preoperative Lysholm score between the two groups had no difference(P>0.05),which was increased at the postoperative 1 month and 6 month,and the score was higher in the observation group(70.59±3.29,84.57±10.22)than in the control group(65.14±3.24,78.54±10.24)(P<0.05).The preoperative VAS score had no difference(P>0.05),which was decreased at the postoperative 1 month and 6 month,and the score was lower in the observation group(21.88±5.54,12.57±8.55)than in the control group(30.19±5.59,24.50±8.59)(P<0.05).The preoperative CRP and IL-6 levels had no difference(P>0.05),while the CRP was increased and the IL-6 was decreased at the postoperative 1 mon and 6 mon,moreover,both levels in the observation group[(13.69±6.18)mg/L,(20.31±10.42)ng/L]were higher than those in the control group[(23.51±6.71)mg/L,(26.51±10.41)ng/L](P<0.05).The clinical total effective rate in the observation group(97.83%)was significantly higher than that in the control group(89.78%,P<0.05).Conclusion Compared with the arthroscopic joint debridement alone,the combination with the microfracture has a better effect on the improvement of knee joint function and decrease of pain degree for KOA patients.
作者
吴磊
朱琳蓉
张广源
牛兴邦
WU Lei;ZHU Linrong;ZHANG Guangyuan(Department of Orthopedics,Affiliated Hospital of Qinghai University,Xining 810000,China)
出处
《临床外科杂志》
2019年第4期313-315,共3页
Journal of Clinical Surgery
