蛇床子素对新生大鼠成骨细胞增殖的影响及相关机制研究

目的:探讨改良Nirschl术式治疗顽固性肱骨外上髁炎的临床疗效.方法:2009年3月至2011年1月,共收治顽固性单纯肱骨外上髁炎21例(21肘),男8例,女13例;年龄25～59岁,平均(48.3±13.4)岁;优势侧16例,非优势侧5例.发病时间8～33个月,平均(17.1±7.7)个月,患者均接受过多种非手术治疗.采用小切口下桡侧腕短伸肌腱起点清理术,即改良Nirschl术式进行治疗,病变涉及指总伸肌腱者予以指总伸肌腱病变部分切除.术后切口部位冰敷2d,石膏托行肘关节制动1周后开始肘部力量和活动度锻炼,腕关节制动2周后行手部和腕部活动度和力量锻炼及正常日常活动.术后随访记录患者休息疼痛情况、手部握力和患者满意度,根据Verhaar网球肘疗效评分评价恢复情况.结果:21例失访4例,17例术后获得随访,时间13～22个月,平均16.3个月.根据Verhaar网球肘疗效评价,结果仇15例,良2例,无肘关节不稳定等并发症出现.结论:单纯顽固性肱骨外上髁炎可通过行改良Nirschl术式取得良好疗效,其关键在于对并发疾病的排除和准确诊断,以及术中病变组织准确切除.     

关节镜微创技术治疗顽固性肱骨内上髁炎

[目的]探讨关节镜微创技术治疗顽固性肱骨内上髁炎的临床应用和疗效.[方法] 2010年1月～2012年7月,顽固性肱骨内上髁炎患者11例(11肘),其中男8例,女3例;年龄19～55岁,平均34岁,9例表现为肱骨内上髁及周围严重疼痛,2例伴有尺神经症状.分别行关节镜下直接入路对变性肌腱病灶清理,经肘关节内入路对肱骨内上髁周围病变的滑膜、关节囊、骨赘和肌腱止点处理,关节镜监视下对合并尺神经症状的进行松解.对比患者术前、术后Mayo评分及VAS评分,进行统计学分析评价手术效果.[结果]11例患者随访5～24个月,平均14个月.术后3个月时Mayo评分(92.2±6.0)较术前(74.5±6.7)有显著提高(P＜0.01),VAS评分(0.9±1.2)较术前(6.5±1.4)显著下降(P＜0.01),术后6个月时Mayo评分显示关节功能进一步改善,VAS评分较前降低;术后(2.8±0.4)个月恢复正常工作及训练.8例患者经过12个月以上随访,肱骨内上髁炎均未复发,肘关节内侧疼痛消失,恢复正常关节功能.未发生神经损伤等并发症.[结论]应用关节镜微创技术治疗顽固性肱骨内上髁炎,病灶处理彻底、手术疗效可靠.     

基于压痛点关节外操作的关节镜手术治疗顽固性肱骨外上髁炎

目的:探讨基于压痛点关节外操作的关节镜手术治疗顽固性肱骨外上髁炎的临床疗效。方法:自2015年10月至2017年9月收治顽固性肱骨外上髁炎患者19例,男7例,女12例;年龄33～62(43.16±8.12)岁;保守治疗时间为7～41(15.47±7.08)个月。19例均采用基于压痛点关节外操作的关节镜手术治疗。观察患者术后并发症情况,术前及术后3个月随访时采用VAS评分、Mayo功能评分进行临床疗效评价。结果:所有患者获得随访,时间6～26(17.16±5.25)个月。术后无感染、皮肤坏死和神经损伤发生。术后6个月无综合握力减弱。VAS评分由术前的4.42±1.17降至至术后3个月的0.53±0.61;Mayo功能评分由术前的62.63±7.88提高至术后3个月的93.42±5.28;根据Mayo功能评分,优17例,良2例。结论:基于压痛点关节外操作的关节镜手术治疗顽固性肱骨外上髁炎采用关节外操作处理关节外主要病变,解剖层次易于理解,视野良好,清理彻底,疗效确切,操作安全。     

手术治疗顽固性肱骨内上髁炎的疗效观察

[目的]探讨手术治疗顽固性肱骨内上髁炎的方法及临床效果。[方法]自2011年6月~2014年4月,共收治顽固性肱骨内上髁炎7例,男3例,女4例;年龄36~54岁,平均45.2岁。术中给予彻底清除旋前屈肌起点病变组织并去除部分内上髁骨皮质。采用VAS、握力及NirschlPettrone分级法对其疗效进行评定。[结果]患者术后切口均Ⅰ期愈合,无相关并发症发生,随访12~30个月,平均16.8个月。患者疼痛明显缓解,握力明显增加。NirschlPettrone分级其中优4例,良3例,可1例。[结论]手术治疗顽固性肱骨内上髁炎是安全且有效的方法。     

成人陈旧肱骨外髁骨折的手术治疗

肱骨外髁骨折是儿童常见的骨折,常发生于2~14岁的儿童,其中6~10岁最常见,分为Milch I型和Milch II型两种类型。儿童肱骨外髁骨折大多经石膏固定或复位后穿针固定而愈合,且功能良好,少数患者因漏诊或处理不当造成不愈合,部分合并明显肘外翻、尺神经炎、疼痛、肘关节不稳定等。儿童陈旧性肱骨外髁骨折,多以肘关节畸形就诊,部分有尺神经炎症状,多主张明确诊断后积极手术治疗。成人陈旧性肱骨外髁骨折,多因承重或提物时疼痛、承重或对抗恐惧感、部分尺神经炎症状或外翻不稳定等问题就诊,较儿童患者易造成骨折不愈合、肘关节活动范围损失和外髁缺血坏死等问题,是否手术治疗存在争论,髁上截骨与骨折固定是否同时进行有争议。2011年5月至2013年10月,我科收治成人陈旧肱骨外髁骨折11例,Milch I型3例、Milch II型8例,术后随访平均时间20.6个月（8~36个月）。对于Milch I型髁上骨折,采用髁上截骨并植骨手术方式;对于Milch II型髁上骨折患者,采用陈旧骨折固定并植骨的手术方式,并处理尺神经炎情况,术中穿针评估手术对活动度影响。1例患者肘外翻明显,行骨折内固定并植骨手术骨折愈合后,二次手术髁上截骨矫正外翻畸形。所有病例最终都获得愈合,疼痛明显减轻或消失,关节稳定,尺神经炎症状消除或明显减轻,肘关节屈伸活动范围平均减少11.4°,前臂旋转减少不明显。整体来说,成人陈旧肱骨外髁骨折可通过手术消除或减轻肘关节承重疼痛和关节不稳症状;术后会减少肘关节活动范围,但大都功能良好;术中需临时固定陈旧骨块检查关节活动,确保术后肘关节活动所受影响不大。     

小切口微血管神经束切断治疗顽固性肱骨外上髁炎

目的评价小切口微血管神经束切断治疗顽固性肱骨外上髁炎的效果。方法对21例顽固性肱骨外上髁炎,以外上髁痛点为中心做2~3cm切口,皮下伸肌筋膜表面找到直径0.2~0.5mm的微血管神经束,切除1~2cm。结果术后随访6~30个月。治愈19例,术后疼痛完全消失,手握力恢复正常;显效2例,术后疼痛及压痛基本消失,手握力基本正常。均未发生并发症。结论小切口微血管神经束切断是治疗顽固性肱骨外上髁炎的有效方法。     

关节镜下Nirschl清理术治疗顽固性网球肘的疗效及镜下分型的临床意义

目的评估关节镜下Nirschl清理术治疗顽固性网球肘的效果和特点，探讨关节镜下分型的临床意义。方法回顾性分析北京大学第三医院2004年至2005年连续收治的用关节镜治疗的23例顽固性网球肘患者（24例肘：男9例，女14例；手术时平均46．2岁）的术后效果。患者术前平均保守治疗时间25．6个月（8～72个月），关节镜下采用Nirschl清理术并对患者按关节镜下分型。用VAS评分，Mayo12点评分，重返工作和体育活动的时间、满意度，肘关节活动范围和握力来评价患者术后效果。结果术后随访时间平均12．6个月（4-23个月），随访率达100％。患者术后休息时、日常活动时和体育锻炼时的疼痛比术前明显缓解，其VAS评分中位数分别是0．00、2．00和5．50，Mayo评分（中位数为11．38）与术前（中位数为4．63）相比差异有统计学意义。术后达到优秀的患者有14例（58．3％），良好的有7例（29．2％），一般的有2例（8．3％），差的有1例（4．7％），总优良率为87．5％。3种分型术前术后疼痛及功能指标差别均无统计学意义。术后未发现严重并发症。结论关节镜下Nirschl清理术是一种治疗顽固性网球肘安全有效的方法，但关节镜下分型的临床意义尚需要进一步研究。     

儿童肱骨外髁骨折合并孟氏骨折二例

<正>1病例介绍例1患儿,男,2岁6个月。因“从约1.5 m高处摔下致左肘疼痛、不敢活动3 h”于2015年5月入院。检查：左肘关节肿胀、压痛,肘关节及前臂因痛拒动,手指屈伸活动正常。X线片、CT及MRI检查示左肱骨外髁骨折、尺骨近端骨折、上尺桡间隙增宽、上尺桡关节损伤。诊断：左肱骨外髁骨折（Milch 1型）、左孟氏骨折,不伴有神经损伤。入院后5 d于全身麻醉下行左肱骨外髁骨折切开复位克氏针固定、尺骨近端骨折闭合复位克氏针固定术。术后长臂石膏托固定,4周后去除石膏开始功能锻炼;术后7周骨折获骨性愈合。     

浮针联合四物汤加味治疗顽固性肱骨外上髁炎的效果分析

目的观察浮针联合四物汤加味治疗顽固性肱骨外上髁炎的临床疗效。方法回顾性分析自2017-03—2018-05采用浮针联合四物汤加味治疗的30例顽固性肱骨外上髁炎。右手持针,左手拇指和食指辅助挟持针身,让针和皮肤刺入角度为15°～20°,到达患处肌层,再退到皮下组织,再将导针收入软管针内,从皮下处向前慢慢推进,然后慢慢提起,切勿让针尖深入。扇形运针,运针100～180 s。结果治疗1个月后16例疼痛感消失,肘关节可正常活动、无功能障碍;14例疼痛明显减轻,肘关节活动基本正常。治疗1个月后所有患者均能自主完成洗脸、解扣、提物及拧毛巾等动作,生活质量明显提高。治疗前疼痛VAS评分为(7.2±1.3)分,治疗后1个月疼痛VAS评分为(1.2±0.8)分;治疗后1个月疼痛VAS评分较治疗前明显降低,差异有统计学意义(P 0.05)。结论浮针疗法配合四物汤加味治疗肱骨外上髁炎体现了中西结合、内外标本兼治的治疗理念,临床操作简便,适宜推广,而且副作用小,患者依从性高。     

改良Nirschl术清理带线锚钉重建桡侧腕短伸肌腱起点治疗顽固性网球肘的临床疗效

目的进行改良Nirschl术清理带线锚钉重建桡侧腕短伸肌腱（extensor carpi radialis brevis tendon,ECRB）起点与单纯改良Nirschl术清理ECRB起点治疗顽固性网球肘的临床疗效比较，探讨带线锚钉重建ECRB起点治疗顽固性网球肘的疗效性及必要性。 方法2013年3月至2016年5月，台州骨伤医院收治的顽固性网球肘患者45例，随机分为观察组和对照组，观察组23例，对照组22例。观察组患者于改良Nirschl术式下切开清理ECRB起点退行性变性肌腱后使用带线锚钉将ECRB重新固定于去除皮质的肱骨外上髁上重建起点，对照组患者于改良Nirschl术式下单纯切开清理ECRB起点退行性变性肌腱。观察比较两组术前及术后2、3、6、12个月的疼痛、握力、重返工作时间、Mayo肘关节功能评分、Verhaar评分。 结果45例患者均完成试验观察，术后切口均为Ⅰ期愈合。观察组术后（4.97±1.33）个月恢复原工作，与对照组术后（3.55±1.27）个月比较，差异有统计学意义（P<0.05）。术后2、3个月Mayo肘关节功能评分观察组均低于对照组，差异有统计学意义（P<0.05），术后12个月Mayo肘关节功能评分观察组优于对照组，差异有统计学意义（P<0.05）；术后12个月两组视觉模拟评分（visual analogue score，VAS）差异有统计学意义（P<0.01）；术后2、3个月握力观察组均低于对照组，差异有统计学意义（P<0.05），术后6、12个月握力观察组均优于对照组，差异有统计学意义（P<0.05）；末次随访Verhaar评分观察组优于对照组，差异有统计学意义（P<0.05 ）。 结论进行改良Nirschl术清理带线锚钉重建ECRB起点治疗顽固性网球肘，手术操作简便，创伤小，将ECRB重新缝合于肱骨外上髁重建起点，恢复其临床解剖位置，使前臂伸肌力量得到最大限度恢复，能使患者恢复至正常的运动和生活水平。     

Mini-open Muscle Resection Procedure under Local Anesthesia for Lateral and Medial Epicondylitis

Background

This study examined the clinical results of surgical treatment using a mini-open muscle resection procedure under local anesthesia for intractable lateral or medial epicondylitis.

Methods

Forty two elbows (41 patients) were treated surgically for lateral or medial epicondylitis. The indication for surgery was refractory pain after six months of conservative treatment, or a history of more than three local injections of steroid, or severe functional impairment in the occupational activities. The treatment results were assessed in terms of the pain using the visual analogue scale (VAS), Roles & Maudsley score, and Nirschl & Pettrone grade.

Results

The preoperative VAS scores of pain were an average of 5.36 at rest, 6.44 at daily activities, and 8.2 at sports or occupational activities. After surgery, the VAS scores improved significantly (p < 0.01): 0.3 at rest, 1.46 at daily activities, and 2.21 at sports or occupational activities. The preoperative Roles & Maudsley score was acceptable in 6 cases, and poor in 36 cases, which was changed to excellent in 23 cases, good in 16 cases, acceptable in 3 cases after surgery. According to the grading system by Nirschl & Pettrone, 23 cases were excellent, 18 cases were good, and the remaining 1 case was fair. Overall, 41 cases (97.6%) achieved satisfactory results. Postoperative complications were encountered in three cases. Subcutaneous seroma due to the leakage of joint fluid in two patients was managed by additional surgery and suction drainage, and resulted in a satisfactory outcome. One patient complained of continuous pain on occupational activity, but her pain at rest was improved greatly.

Conclusions

The mini-open muscle resection procedure under local anesthesia appears to be one of effective methods for intractable lateral or medial epicondylitis.     

Nirschl手术治疗顽固性网球肘:切开与关节镜手术比较

目的 比较切开和关节镜手术治疗顽固性网球肘的临床疗效.方法 2006年5月至2008年9月连续收治顽固性网球肘患者26例(28例肘),手术时患者平均年龄45岁(32～62岁),保守治疗时间为23个月(4～60个月).手术方式以Nirschl术为原则,按照随机表随机分为切开组(13例13肘)和关节镜组(13例15肘).采用VAS疼痛评分、Mayo功能评分、肘关节综合评分、重返工作和运动时间、满意度等评价患者术后效果.结果 26例患者均获随访,随访时间4～32个月,平均17.4个月.两组术后效果比较,在VAS疼痛评分中的静息和日常活动评分、综合评分、重返工作和运动时间、满意度及术后效果评价等级方面,两组均无显著差异.而在VAS评分的运动评分及Mayo功能评分中,切开组优于关节镜组.切开组满意或部分满意患者100%,关节镜组86.7%.切开组优良率100%,关节镜组93.3%.术后未发现严重并发症.结论 切开和关节镜手术均是治疗顽固性网球的有效方法,切开手术在术后恢复运动等肘关节功能方面优于关节镜手术,可能与切开术中有更多伸肌腱裂口被缝合有关.     

Autologous blood injections for refractory lateral epicondylitis

PURPOSE: Most nonsurgical treatments for lateral epicondylitis have focused on suppressing an inflammatory process that does not actually exist in conditions of tendinosis. An injection of autologous blood might provide the necessary cellular and humoral mediators to induce a healing cascade. The purpose of this study was to evaluate prospectively the results of refractory lateral epicondylitis treated with autologous blood injections. METHOD: Twenty-eight patients with lateral epicondylitis were injected with 2 mL of autologous blood under the extensor carpi radialis brevis. All patients had failed previous nonsurgical treatments including all or combinations of physical therapy, splinting, nonsteroidal anti-inflammatory medication, and prior steroid injections. Patients kept personal logs and rated their pain (0-10) and categorized themselves according to Nirschl staging (0-7) daily. RESULTS: The average follow-up period was 9.5 months (range, 6-24 mo). After autologous blood injections the average pain score decreased from 7.8 to 2.3. The average Nirschl stage decreased from 6.5 to 2.0. For the 9 patients receiving more than one blood injection the mean pain score and Nirschl stage before injection were 7.2 and 6.6, respectively. After the second blood injection the pain and Nirschl scores were both 0.9. Two patients received a third blood injection that brought both pain and Nirschl scores to 0. CONCLUSIONS: After autologous blood injection therapy 22 patients (79%) in whom nonsurgical modalities had failed were relieved completely of pain even during strenuous activity. This study offers encouraging results of an alternative minimally invasive treatment that addresses the pathophysiology of lateral epicondylitis that has failed traditional nonsurgical modalities.     

Prospective Evaluation of the Effectiveness of a Home-Based Program of Isometric Strengthening Exercises: 12-Month Follow-up

Background

The aim of this prospective randomized clinical trial was to investigate the efficacy of a home-based program of isometric strengthening exercises for the treatment of the lateral epicondylitis (LE) of the distal humerus. We hypothesized that 1) use of isometric strengthening exercises would result in clinical benefits similar to those provided by medication and pain relief and 2) functional improvements after exercise would be time-dependent.

Methods

Patients were assigned to one of two groups: 1) an immediate physical therapy group (group I), or 2) a delayed physical therapy group (group D). Group I patients (n = 16) were instructed how to do the exercises at their first clinic visit and immediately carried out the exercise program. Group D patients (n = 15) learned and did the exercises after being on medications for 4 weeks.

Results

Outcomes at the 1-month clinic visit indicated that pain (measured using a visual analogue scale [VAS]) had been significantly reduced in group I compared to group D (p < 0.01). However, significant differences between groups were not found at 3-, 6-, and 12-month follow-up for either VAS scores or Mayo elbow performance scores. For modified Nirschl/Pettrone scores, a significant difference between groups was found only at the 1-month follow-up visit. By then, the number of participants who returned to all activities with no pain or occasional mild pain was six (37%) in Group I and two (13%) in Group D (p = 0.031). At the final follow-up visit, 88% of all participants performed physical activities without pain.

Conclusions

Isometric strengthening exercises done early in the course of LE (within 4 weeks) provides a clinically significant improvement.     

帕瑞昔布钠对全膝关节置换术后股神经阻滞镇痛及膝关节功能恢复的影响--前瞻、双盲、随机对照研究

目的：评价帕瑞昔布钠对全膝关节置换术后连续股神经阻滞的镇痛效果及对早期膝关节功能恢复的影响。方法2012年5～12月择期行全膝关节置换术患者100例,于腰麻硬膜外联合麻醉前行连续股神经阻滞并用于术后镇痛。患者以随机、双盲形式分为2组：连续股神经镇痛组（ C组）和帕瑞昔布钠联合连续股神经镇痛组（ P组）,P组于切皮前30 min和术后12、24、36和48 h静脉注射帕瑞昔布钠40 mg,C组给予等量生理盐水。术后对2组静息和被动运动时膝关节前后部疼痛视觉模拟评分（ visual analogue scale ,VAS）、镇痛泵按压次数、主动直腿抬高时间、被动屈膝90°时间、术前及术后72 h美国特种外科医院膝关节评分（ Hospital for Special Surgery Knee Score ,HSS）进行评估。结果静息时膝关节前部VAS评分各时点2组相似（P＞0．05）,后部VAS评分在术后8、12、24、48 h时P组比C组降低（P＜0．05）;膝关节被动运动时前部VAS评分在24、48 h时P组比C组降低（P＜0．05）,后部VAS评分在24 h时P组比C组降低（P＜0．05）;镇痛泵按压次数在术后4～8 h及8～12 h时间段P组比C组减少（P＜0．05）;2组术前、术后72 h HSS评分差异无显著性（P＞0．05）;主动直腿抬高时间、被动屈膝90°时间P组比C组缩短（P＜0．05）。结论帕瑞昔布钠对全膝关节置换术后连续股神经阻滞的患者在一定程度上缓解疼痛,缩短主动直腿抬高时间、被动屈膝90°时间从而部分改善早期膝关节功能,具有较好的促进恢复作用。     

Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow

Background:

Platelet rich plasma (PRP) extract has shown to be a general stimulation for repair and currently used widely in various sports injury. A prospective observational study was done to assess the efficacy of autologous PRP injection in lateral epicondylitis of elbow, and compare the result with low level laser therapy.

Materials and Methods:

The trial was conducted at a tertiary care center for a period of 2 years. Eighty-one patients with chronic lateral epicondylitis were divided into two groups. PRP group (n = 39) and laser therapy group (n = 42). The primary analysis included Nirschl pain score, local tenderness, pain on wrist extension, grip strength, elbow swelling were clinically assessed at different interval of followup (minimum followup: 52 weeks) and; clinical and functional outcome evaluated at final followup. The statistical analysis were done.

Results:

The mean Nirschl pain score decreased significantly from baseline in PRP when compared with low level laser therapy (P ≤ 0.05).

Conclusions:

Treatment of patients with chronic lateral epicondylitis with PRP extract reduced pain and significantly increased function, exceeding the effect of low level laser therapy on long term followup. Low-level laser therapy is better in the short term period, but on long term followup injection PRP therapy is better than laser therapy in lateral epicondylitis.     

Common extensor origin release in recalcitrant lateral epicondylitis - role justified?

The aim of our study was to analyse the efficacy of operative management in recalcitrant lateral epicondylitis of elbow. Forty patients included in this study were referred by general practitioners with a diagnosis of tennis elbow to the orthopaedic department at a district general hospital over a five year period. All had two or more steroid injections at the tender spot, without permanent relief of pain. All subsequently underwent simple fasciotomy of the extensor origin. Of forty patients thirty five had improvement in pain and function, two had persistent symptoms and three did not perceive any improvement. Twenty five had excellent, ten had well, two had fair and three had poor outcomes (recurrent problem; pain at rest and night). Two patients underwent revision surgery. Majority of the patients had improvement in pain and function following operative treatment. In this study, an extensor fasciotomy was demonstrated to be an effective treatment for refractory chronic lateral epicondylitis; however, further studies are warranted.     

股神经和硬膜外自控镇痛在全膝关节置换术后的效果比较

目的：比较股神经和硬膜外自控镇痛在膝关节置换术后的效果和副作用。方法：选择ASAⅠ～Ⅱ级行单侧膝关节置换术患者50例,随机分为股神经自控镇痛组（PCFNA,n=25）和硬膜外自控镇痛组（PCEA,n=25）。均在单侧蛛网膜下腔阻滞麻醉下施术,术后通过留置导管连接0.2%罗哌卡因、2μg/mL芬太尼止痛泵镇痛。结果：两组在术后各时点静息VAS和吗啡用量、副作用的发生率无统计学差异。PCFNA组持续被动功能训练时的VAS疼痛评分均明显低于PCEA组患者（P〈0.01）;PCFNA组术后24h患肢股四头肌的肌力略低,非手术侧肌力略高（P〈0.000）。结论：股神经自控镇痛在持续被动运动镇痛效果优于硬膜外自控镇痛,不影响非手术侧股四头肌肌力,有利于早期下床活动。     

平衡针法治疗膝骨性关节炎的临床疗效观察

目的：观察平衡针法治疗膝骨性关节炎的临床疗效,为临床治疗本病提供更有效的治疗方法。方法：将61例符合纳入标准的观察对象,按首次来诊的先后顺序,用随机数字表法随机分为两组,治疗组31例采用平衡针法针刺,对照组30例采用传统针刺。两组病例均每日治疗1次,6次为1疗程,疗程间间隔3－4d,临床观察2个疗程后进行视觉模拟定级WAS）评定、膝关节症状和体征分级量化,并判定疗效。结果：①在VAS评分方面,两组VAS积分自身前后比较均有显著性差异（P〈0．01）,两组间治疗后比较有显著性差异（P〈0．05）;②在膝关节症状和体征改善方面,两组症状和体征总积分自身前后比较均有显著性差异（P〈0．01）,两组间治疗后比较有显著性差异（P〈0．05）,其中两组间治疗后行走时疼痛、关节肿胀、关节活动度比较有显著性差异（P〈0．05）,晨僵或起床后疼痛、休息时疼痛比较无显著性差异（P〉0．05）;③治疗组总有效率为93．54％,对照组总有效率为83．3％,两组比较有显著性差异（P〈0．05）。结论：①在VAS评分方面,两种疗法均能改善膝关节疼痛,治疗组优于对照组;②在膝关节症状和体征改善方面,两组均能改善膝关节症状和体征,其中治疗组在改善行走时疼痛、关节肿胀、关节活动度方面优于对照组,在晨僵或起床后疼痛、休息时疼痛方面,两组有类似的疗效;③治疗组临床疗效优于对照组,平衡针治疗本病有一定优势。