单髁置换术治疗老年人内侧单间室膝骨关节炎的临床疗效

目的分析固定平台单髁置换术治疗老年内侧单间室骨关节炎的临床疗效。方法解放军总医院骨科2005年1月至2010年3月收治膝关节骨关节炎患者38例,男14例,女24例;年龄60~72(66.0±5.6)岁。站立行走内侧关节间隙疼痛,术前膝关节正侧位X线等影像学检查提示内侧单间室膝骨关节炎。术前美国特种外科医院(HSS)评分(52.6±16.7),疼痛视觉模拟量表(VAS)评分(6.3±1.2),膝关节内翻畸形(8.9±1.6)°,关节活动度(112.6±23.5)°。结果手术时间(45.0±10.2)min,无血管、神经等副损伤,伤口均Ⅰ期愈合,无切口感染等并发症发生;所有患者均随访,无死亡、退出等情况,随访时间71~133(102.0±12.2)个月。末次随访时,膝关节HSS评分(91.8±17.9),VAS评分(1.8±0.9),膝关节内翻畸形(4.7±0.9)°,关节活动度(129.7±36.8)°;与术前相比,均具有显著的改善(P0.05)。结论固定平台单髁置换术治疗老年内侧单间室骨关节炎具有较好的临床疗效。     

超声引导下局部注射皮质类固醇混合制剂治疗老年性膝骨关节炎的止痛疗效

目的本文探讨了超声引导下局部注射皮质类固醇混合制剂治疗老年性膝骨关节炎的止痛疗效。方法入选2015年5月至2015年12月期间在武警总医院超声科行超声引导下局部注射皮质类固醇混合制剂治疗的膝骨关节炎患者31例(35个膝骨关节)。皮质类固醇混合制剂采用曲安奈德、2%利多卡因和注射用水以2:1:1的容积比例配制。比较术前、术后4周和术后6个月患者的疼痛视觉模拟量表(VAS)评分结果。术后6个月对患者进行疗效满意度调查。结果超声引导下注射皮质类固醇混合制剂治疗膝骨关节炎的一次成功率为100%。与术前(5.2±1.5)相比,术后4周(0.5±0.7)和术后6个月(1.0±1.2)的VAS评分均显著降低,差异均具有统计学意义(P0.05),而术后4周和术后6个月相比,差异无统计学意义(P0.05)。术后6个月疼痛消失或明显缓解者为33例,占94.2%,患者满意度达到为91.4%。结论应用超声精准定位和实时引导,局部注射皮质类固醇混合制剂治疗老年性膝骨关节炎具有良好的消炎止痛效果,值得推荐。     

The Knee Osteoarthritis Grading System for Arthroplasty

Background

The aim of this study is to validate the Knee Osteoarthritis Grading System (KOGS) of progressive osteoarthritic degeneration for the tri-compartmental knee. This system defines the site and severity of osteoarthritis to determine a specific knee arthroplasty.

Early elbow osteoarthritis in competitive enduro motorcyclist

This case report speculates that prolonged vibration from enduro off-road sport is deleterious for the elbow joint. This contribution could also aid sports physicians in better understanding this complex unknown phenomenon. No published data are present in the current literature that demonstrates the correlation between early elbow osteoarthritis in enduro motorcyclist overuse.     

Comparison of the treatment results of knee osteoarthritis using adipose tissue mesenchymal stromal cells derived through enzymatic digestion and mechanically fragmented adipose tissue

Introduction:Knee osteoarthritis is a common condition that affects daily functioning and decreases the quality of life. There are many ways of treatment depending on the stage of the disease. Advanced cases are qualified for arthroplasty, which is an extensive and demanding surgical procedure. Less advanced stages are treated in various ways: from rehabilitation, through oral and intra-articular pharmacotherapy, to surgical treatment (arthroscopy, osteotomy). Because surgical treatment is risky, scientists focus on less invasive therapeutic methods. The most valuable management is based on regeneration. Mesenchymal stromal cells (MSC) derived from the adipose tissue have a great regenerative and anti-inflammatory potential, therefore an attempt is being made to take advantage of them in knee osteoarthritis treatment.The study aims to compare the clinical effects of treatment of knee osteoarthritis using adipose tissue MSC obtained by an enzymatic method with the outcomes of the therapy with the mechanically fragmented adipose tissue.Methods:One hundred adults with primary knee osteoarthritis will undergo lipoaspiration under sterile conditions. The collected lipoaspirates will be further processed, depending on the randomly assigned group-enzymatically with the use of collagenase or mechanically using the Lipogems system. The preparations will be administered to the patients’ knee joints in the operating room under ultrasound control.The results of treatment will be assessed using Knee Injury and Osteoarthritis Outcome Score, measuring the flexibility of the knee joint, evaluating joint gap in X-ray and the quality of cartilage in magnetic resonance T2-mapping during 1 year after treatment.Discussion/conclusion:Identification and functional analysis of the regenerative capacity of adipose-derived MSC depending on three variables (body weight, sex, and age) will help to develop a targeted therapy for different groups of patients and will determine the effectiveness of both methods of treatment. An attempt will be made to identify groups of patients with the greatest regenerative potential of the adipose tissue, and thus indicate those with the most probable improvement of the joint condition.Trial registration:This study protocol has been approved by the Ethics Committee of Medical University of Warsaw and registered on www.clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT04675359","term_id":"NCT04675359"}}NCT04675359 (06 Jan 2021)     

穴位敷贴结合运动疗法对膝骨性关节炎的治疗价值评估

目的探讨穴位敷贴联合运动疗法对膝骨性关节炎的治疗效果。方法100例膝骨性关节炎患者,按照随机摸球法分为实验组与参照组,各50例。实验组应用穴位敷贴结合运动疗法治疗,参照组口服非甾体消炎止痛药治疗。比较两组治疗效果。结果实验组的优良率80.00%与参照组的78.00%比较,差异无统计学意义(P>0.05)。结论两种治疗方案都可实现治疗膝骨性关节炎的目的,穴位敷贴联合运动疗法治疗膝骨性关节炎具有成本低、价格便宜、经济实惠等优势。     

独活寄生汤加减联合微波针治疗膝骨性关节炎60例疗效观察

目的:探讨独活寄生汤加减联合微波针治疗膝骨性关节炎的临床疗效。方法:回顾性分析2018年1月-2019年3月我院收治的60例膝骨性关节炎患者的临床资料,对照组30例,只采用常规西医治疗。观察组30例,联合独活寄生汤加减与微波针灸治疗,评估临床效果。结果:①临床疗效:观察组治疗有效率显著高于对照组(P<0.05);②相关指标:观察组白介素-1β(IL-1β),肿瘤坏死因子-α(TNF-α),基质金属蛋白酶(MMP-3)水平明显低于对照组(P<0.05);③症状积分:观察组关节疼痛、晨僵、关节肿胀积分明显低于对照组(P<0.05)。结论:在膝骨性关节炎的临床治疗中,独活寄生汤加减与微波针联合治疗能够有效减轻患者的临床症状,改善临床指标,提高临床疗效,具备较高的应用价值,值得推广。     

基于红外热成像技术的膝骨性关节炎患者穴位体表温度规律研究＊

目的 观察膝骨性关节炎患者穴位体表温度分布规律。方法 以256例膝骨性关节炎患者和256例健康受试者为观察对象。使用Fotric 226红外热像仪检测患者和健康受试者腧穴的温度值，每名患者每周固定时间检测1次，共检测4次，健康人检测1次，比较患者组与健康受试者组穴位温度值的差异，比较不同时间点不同部位、经脉温度值的差异。结果 膝骨性关节炎患者血海穴、鹤顶穴、梁丘穴、曲泉穴、内膝眼穴、犊鼻穴、委阳穴、阴陵泉穴、膝关穴、阳陵泉穴、大杼穴、悬钟穴、足三里穴、命门穴、腰阳关穴温度值高于健康受试者（P < 0.05）；患者组胃经的4次皮温均较高（P < 0.05），腰背部的4次皮温均较高（P < 0.05）；KOA相关腧穴4次温度值变化趋势不显著（P > 0.05）。结论 膝关节骨性关节炎患者部分腧穴皮温升高；膝骨性关节炎患者的穴位升温现象具有规律性，与经络、部位相关；膝关节骨性关节炎相关穴位升温效应具有稳定性。