三联疗法治疗膝关节骨性关节炎

目的 观察关节内注射透明质酸钠配合局部痛点封闭加针刀微创手术的三联疗法对膝关节骨性关节炎（KOA）的临床效果.方法 将272例KOA患者分为治疗组和对照组,每组各136例,对照组采用局部痛点封闭加针刀微创手术治疗,治疗组在对照组的基础上加用关节腔注射透明质酸钠药物治疗.结果 治疗6周后,治疗组临床治愈率及总有效率均明显优于对照组（P＜0.05）,随访1年后,治疗组的阳性复发率明显低于对照组（P＜0.05）.结论 三联疗法治疗KOA,效果明显优于局部痛点封闭加针刀微创手术疗法.     

膝关节骨关节炎的治疗

目的:探讨膝关节骨关节炎的治疗方法.方法:对324例407膝膝骨关节炎疼痛患者,临床分期为软组织损害型:关节内轻中度病损型;关节内重度病损型.分别进行保守综合治疗,关节镜治疗及全膝关节表面置换治疗.结果:平均随访71个月,优良率79.1%.结论:对于膝关节骨关节炎疼痛进行分期,而后选择适当疗法,治疗效果满意.     

聚蛋白多糖酶与膝骨关节炎相关性研究

目的 观测并探讨膝骨关节炎关节液及血清中聚蛋白多糖酶(ADAMTSs)水平与病变程度的关系.方法 单侧膝骨关节炎87例中,早期为45例,中晚期为42例.检测其患侧膝关节液和血清中ADAMTSs水平.以健康志愿者30例为正常对照组.结果 膝骨关节炎患者关节液及血清中ADAMTSs水平均高于正常对照组,随着病变程度加重,膝关节液及血清中ADAMTSs水平显著增加,关节液与血清中ADAMTSs水平存在线性相关关系.结论 ADAMTSs水平在骨关节炎患者膝关节液和血清中均升高,与病变程度密切相关,检测关节液及血液该种指标有助于病情早期诊断.     

Acupuncture for osteoarthritis of the knee

About 10% of people aged over 55 years in the UK report having some restriction of daily activity because of knee osteoarthritis, around 25% of whom are severely disabled. Every year, symptomatic knee osteoarthritis accounts for about 0.5% of all primary care consultations in those over 55 years, rising to 1% in those over 70 years. Acupuncture is increasingly being used within the NHS, particularly for painful conditions such as osteoarthritis, but its place within mainstream healthcare remains controversial. Here we examine what, if anything, acupuncture offers in the management of patients with osteoarthritis of the knee.     

尪痹片治疗膝骨关节炎的疗效

目的观察比较尪痹片和美洛昔康治疗膝骨关节炎的疗效和不良反应。方法 60例膝骨关节炎患者随机分为观察组和对照组,分别给予尪痹片和美洛昔康治疗6周,比较两组临床疗效。结果两组患者症状均明显改善,而不良反应发生率观察组明显少于对照组,两组比较,差异有统计学意义(P<0.05)。结论两种药物对骨关节炎均有效,尪痹片的不良反应更少,值得临床推广。     

膝关节骨性关节炎的关节镜治疗

目的评价膝关节镜手术治疗骨性关节炎的临床疗效。方法采用滑膜部分切除、骨赘咬除、半月板修整或成形、游离体摘除、软骨修整、软骨下骨钻孔等方法治疗骨性关节炎病例110例,左膝36例,右膝74例。结果所有病人随访,平均随访16月;优良率为91.7%,差为8.3%。结论关节镜手术是治疗早、中期膝骨性关节炎的一种较好的方法,具有创伤小、恢复快、疗效确切等优点,值得推荐。     

Treating knee osteoarthritis with intra-articular hyaluronans

ABSTRACT

Objective: Intra-articular hyaluronan (HA) or hylan is approved for the treatment of osteoarthritis (OA) knee pain. The authors review here published evidence of efficacy and safety of intra-articular HA for the treatment of knee pain. Since the systemic safety of nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase (COX-2) inhibitors for OA knee treatment are a current concern, the authors also offer recommendations for repositioning HA in the OA treatment paradigm.

Methods: Relevant HA literature was identified by searching MEDLINE and EMBASE from their inception to April 2008 using the search words hyaluronan, hyaluronic acid, sodium hyaluronate, and hylan G-F 20, with knee and OA. Data from randomized, placebo-controlled trials were reviewed and summarized in this article. While not a systematic review, this article reviews the best available evidence for the use of HA to treat knee OA.

Results: For the most part, patients in the reviewed studies were adults over the age of 40 with mild to severe symptomatic OA of the knee. Reviewed studies demonstrated significant improvements in pain and physical function with HA or sodium hyaluronate and hylan G-F 20. HA or hylan products were most effective between 5 and 13 weeks after injection with improvements also observed at 14–26 weeks or sometimes longer, and were well tolerated with a low incidence of adverse events. HA also provides beneficial treatment effects when administered in conjunction with other therapies.

Conclusions: Intra-articular HA or hylan has proven to be an effective, safe, and tolerable treatment for symptomatic knee OA. In an effort to limit cardiovascular, gastrointestinal, and renal safety concerns with COX-2 selective and nonselective NSAIDs and maximize HA efficacy, the authors proposed using HA earlier in the treatment paradigm for knee OA and also as part of a comprehensive treatment strategy.     

Acupuncture for osteoarthritis of the knee

Miller E, Maimon Y, Rosenblatt Y et al. Delayed effect of acupuncture treatment in OA of the knee: a blinded, randomized, controlled trial. Evid Based Complement Altern Med 2011; Article ID 792975. doi:10.1093/ecam/nen080     

膝关节骨关节炎关节镜清理术的疗效

目的 探讨关节镜清理术治疗膝关节骨关节炎(OA)的疗效.方法 在关节镜下行选择性、有限关节清理术76例,按Lysholm膝关节评分标准对92膝术前、术后6个月、1、2年进行评分.结果 92膝膝关节术前Lysholm评分(44.78±8.79)分,术后6个月、1、2年综合评分分别为(77.08±8.34)分、(76.38±8.74)分和(69.60±10.44)分,均较术前明显提高(P<0.05).术后2年的评分明显低于术后6个月和1年(P<0.05).结论 关节镜清理术治疗膝关节骨关节炎能够减轻疼痛、改善功能,2年内疗效好.     

Vitamin supplementation may protect against knee osteoarthritis

Wilder FV, Leaverton PE, Rogers MW, Lemrow NB. Vitamin supplements and radiographic knee osteoarthritis: the Clearwater osteoarthritis study. J Musculoskelet Res 2009; 12: 85–93.     

玻璃酸钠联合氨基葡萄糖治疗膝骨性关节炎

目的：探讨玻璃酸钠联合氨基葡萄糖治疗膝骨性关节炎（OA）有效性及安全性。方法：将162例膝OA患者随机分成观察组和对照组,对照组84例采用单纯关节内注射透明玻璃酸纳,观察组78例采用关节腔内注射玻璃酸钠联合氨基葡萄糖治疗膝骨性关节炎,比较两组Lysholm膝关节评分。结果：随访12个月后对两组行Lysholm膝关节评分及关节功能评价,两组间比较,差异有统计学意义（P〈0．05）。结论：玻璃酸钠联合氨基葡萄糖治疗膝骨性关节炎治疗效果优于单纯关节腔内注射透明玻璃酸钠,有临床应用价值。     

Pharmacotherapy for knee osteoarthritis: current and emerging therapies

ABSTRACT

Introduction

Osteoarthritis (OA) is the leading cause of pain, loss of function and disability in the elderly, with the knee being the most impactful joint affected. Currently, there is still no ‘cure’ in OA treatment.     

膝骨性关节炎的发病机制及降钙素的治疗作用

目的探讨膝骨性关节炎(KOA)的发病机制及降钙素(CT)的治疗作用。方法 36只白兔随机均分为空白对照组(A组)、KOA模型组(B组)、CT 5U.kg-1.d-1治疗组(C组)。20d后处死动物,检测血清及关节液超氧化物歧化酶(SOD)活性及丙二醛(MDA)、一氧化氮(NO)含量,HE染色观察关节软骨病理组织学变化,免疫组织化学染色法检测软骨组织Ⅱ型胶原和基质金属蛋白酶1(MMP-1)蛋白表达情况。结果与A组相比,B组关节软骨损伤加重,Mankin’s评分、MDA及NO含量、MMP-1蛋白表达增加(P<0.05),SOD活性及Ⅱ型胶原含量降低(P<0.05);而C组能明显逆转B组上述各观察指标的改变过程(P<0.05)。结论 KOA的发生与机体氧化-抗氧化系统、细胞外基质合成-分解代谢系统的失衡密切相关,且CT对KOA的治疗作用与这两个系统失衡的恢复有关。     

全膝关节表面置换术治疗膝骨性关节炎的效果观察

目的 探讨全膝关节表面置换术治疗膝骨性关节炎的临床效果。方法 选取本院2010年1月~2012年12月收治的膝骨性关节炎患者20例,共22膝,对所有患者行人工全膝关节表面置换术治疗。结果 根据HSS评分标准,20例患者中,优秀16例（80%）,良好3例（15%）,尚可1例（5%）,差0例,优良率为95%（19/20）。术前HSS评分为（48.5±11.3）分,术后2周的HSS评分为（83.8±10.2）分,术后半年的HSS评分为（91.5±7.4）分,术后的HSS评分明显高于术前,差异有统计学意义（P〈0.05）。结论 全膝关节表面置换术治疗膝骨性关节炎具有良好的临床效果,安全可靠,值得临床推广。