关节镜清理术联合中药熏洗治疗膝关节骨性关节炎的临床疗效

目的 观察关节镜下清理术联合中药熏洗治疗膝关节骨性关节炎(KOA)的临床疗效.方法 选择膝关节骨性关节炎患者60例,随机分为对照组30例(38膝)及观察组30例(44膝).两组患者均采用关节镜下清理术治疗,观察组术后给予中药局部熏洗,对照组术后给予温水熏洗.于治疗前及治疗后1、3、6个月,对两组进行Lysholm膝关节功能评分及疼痛视觉模拟评分(VAS).治疗后6个月比较两组的中医临床疗效.结果 治疗后6个月,观察组的中医临床疗效优于对照组(P＜0.05).治疗后各时间点观察组Lysholm评分高于对照组(P＜0.05),两组的Lysholm评分随观察时间的延长而升高(P＜0.05);治疗后各时间点观察组VAS评分低于对照组(P＜0.05),两组的VAS评分随观察时间的延长而降低(P＜0.05).两组患者术后均未出现手术部位感染.结论 关节镜清理术联合中药熏洗治疗KOA临床疗效优于单纯关节镜清理术.     

关节镜辅助下关节清理术结合康复训练治疗膝关节骨性关节炎的临床研究

目的:研究关节镜辅助下关节清理术结合康复训练对膝关节骨性关节炎（KOA）的临床疗效。方法:收集确诊为KOA的病人138例（均为单膝）,随机分为2组,对照组进行单纯关节镜下清扫术治疗,观察组进行关节镜下清扫术结合康复训练,比较2组不同分期KOA病人治疗前后的膝关节功能评分（Lysholm评分）以及疼痛评分（VAS评分）。结果:所有病人治疗2个月后,不同Kellgren-Lawrence X线分级KOA病人VAS评分均较治疗前明显降低（P<0.01）,Lysholm评分均明显升高（P<0.01）。治疗后2个月,2组对应的Kellgren-Lawrence X线分级Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级病人VAS评分显著低于治疗前（P<0.01）,Lysholm评分显著高于治疗前（P<0.01）;观察组Ⅰ级和Ⅱ级病人VAS评分显著低于对照组（P<0.01）,Lysholm评分则显著高于对照组（P<0.01）;2组Ⅲ级、Ⅳ级病人膝关节疼痛及功能评分差异均无统计学意义（P>0.05）。观察组行关节镜下清理术结合康复训练后总有效率高于对照组（P<0.05）。结论:关节镜辅助下关节清理术能明显改善KOA病人膝关节功能并减轻其疼痛,术后结合康复训练能进一步减轻Ⅰ级和Ⅱ级病人的痛感并改善膝关节功能。     

关节镜下有限清理与广泛清理术治疗膝骨性关节炎的疗效比较

目的探讨关节镜下有限清理与广泛清理术治疗膝骨性关节炎(KOA)的疗效比较。方法选取2015年1月~2017年6月间于我院骨科住院拟行关节镜下关节清理术治疗的膝关节OA的患者74例,随机分为观察组和对照组。对照组与观察组患者分别予以关节镜下有限清理术与广泛清理术。观察并比较两组患者手术时间、术后疼痛评分、术后恢复时间及膝关节功能和临床疗效。结果观察组的手术时间、术后疼痛评分及术后恢复时间明显长于对照组(P0.05)。手术后,两组膝关节HSS评分较前明显上升(P0.05),且治疗后两组膝关节HSS评分比较差异无统计学意义(P0.05);两组临床效果优良率比较差异无统计学意义(χ~2=0.14,P0.05)。结论关节镜下有限清理术与广泛清理术治疗KOA的短期疗效相当,前者手术时间短、术后疼痛轻、术后恢复快,宜作为首选术式。     

关节镜下微创有限清理术治疗膝骨关节炎的效果

目的探讨基于关节镜微创有限清理术治疗膝骨关节炎的效果。方法选择2016年3月至2017年4月于广东省深圳市宝安区人民医院接受关节镜治疗的73例膝骨关节炎患者,按入院顺序分为A组(37例)和B组(36例)。A组接受关节镜下广泛清理术治疗,B组接受关节镜下微创有限清理术治疗。比较两组治疗总有效率、膝关节Lysholm评分和VAS评分。结果 A组患者术后3周、1个月的VAS评分及膝关节Lysholm评分均低于B组,差异有统计学意义(P<0.05)。B组总有效率(100.0%)高于A组(75.7%),差异有统计学意义(P<0.05)。随访4~6周,两组均无并发症发生。结论关节镜下微创有限清理术治疗膝骨关节炎效果显著,可缓解疼痛,改善膝关节功能。     

关节镜下清理术联合髁间窝成形术对老年膝骨关节炎治疗效果和安全性的比较研究

目的 探讨关节镜下清理术联合髁间窝成形术对老年膝骨关节炎的治疗效果和安全性.方法 选择2012年6月至2014年12月该院收治的老年膝骨关节炎患者68例,分为A组和B组,每组34例.A组给予关节镜下清理术,B组给予关节镜下清理术联合髁间窝成形术.比较两组患者术后3个月、6个月和12个月视觉模拟评分法(VAS)评分、Lysholm评分、WOMAC评分和关节活动度,统计两组患者术后出现的不良反应事件及其发生率.结果 术后两组患者VAS评分和WOMAC评分均显著性降低(P＜0.05);与A组比较,B组患者在术后12个月VAS评分和WOMAC评分更低(P＜0.05).术后两组患者的Lysholm评分均升高(P＜0.05),B组患者在术后12个月Lysholm评分显著高于A组(P＜0.05).术后两组患者的关节活动度均得到显著改善(P＜0.05),术后6个月和12个月B组患者的膝关节活动度明显优于A组(P＜0.05).术后早期关节肿胀是两组患者出现的不良反应事件,两组比较差异无统计学意义(P＞0.05).结论 关节镜下清扫联合髁间窝成形术可以有效缓解患者关节疼痛,提高治疗效果,改善患者膝关节功能.     

射频辅助关节镜有限清理术治疗膝骨性关节炎的效果观察

目的: 探讨射频技术辅助关节镜有限清理术对膝骨性关节炎的治疗效果.方法: 将48例膝骨性关节炎患者随机分为射频组24例经关节镜采用射频技术治疗;常规组24例经关节镜采用常规的手术器械和电动刨削器治疗.比较2组患者术前、术后1年Lysholm评分和术后2周内关节积液量.结果: 2组术前Lysholm评分差异无统计学意义(P >0.05).2组患者术后Lysholm评分均较术前明显提高(P< 0.01),而且2组患者术后1年Lysholm评分差异有统计学意义(P< 0.01);射频组术后2周内膝关节积液量明显少于常规组(P< 0.01).结论: 射频技术辅助膝关节镜有限清理术治疗膝骨性关节炎有助于提高疗效,值得推荐.     

关节镜有限清理联合玻璃酸钠治疗老年膝骨性关节炎疗效分析

目的探讨关节镜有限清理联合玻璃酸钠关节腔内注射治疗老年膝骨性关节炎的临床疗效。方法将我院2008～2011年收治的老年膝骨性关节炎患者98例(125膝),随机分为A、B和C三组,A组30例(39膝)接受关节镜有限化清理治疗,B组35例(45膝)接受玻璃酸钠关节腔内注射治疗,C组33例(41膝)接受关节镜有限清理联合玻璃酸钠关节腔内注射治疗。观察并比较术后1周关节疼痛和功能评分以及术后3个月的临床疗效。结果治疗后1周C组在关节疼痛和功能评分方面均显著高于其他两组(P<0.05),治疗后3个月C组总有效率为90.2%,显著高于其他两组(P<0.05)。结论关节镜有限清理联合玻璃酸钠关节腔内注射方法安全、创伤小、效果显著,适于老年膝骨性关节炎的治疗。     

关节镜下关节腔清理术治疗痛风性膝关节炎的效果

目的探讨关节镜下关节腔清理术治疗痛风性膝关节炎的效果。方法选择2014年6月至2017年8月舞钢市人民医院收治的93例痛风性膝关节炎患者,按治疗方案分为对照组(46例)和观察组(47例)。对照组口服塞来昔布,观察组接受关节镜下关节腔清理术治疗。比较两组疼痛程度[视觉模拟评分量表(VAS)评分]、膝关节功能[Lysholm膝关节功能评分量表评分(Lysholm knee score,LKSS)]和生活质量[健康状况调查量表(SF-36)评分],统计两组不良反应发生率。结果治疗后,两组VAS评分均较治疗前降低,且观察组低于对照组,LKSS均较治疗前提高,且观察组LKSS、VAS评分均高于对照组,差异有统计学意义(均P<0.05)。治疗后,两组SF-36评分均较治疗前提高,且观察组高于对照组,差异有统计学意义(均P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用关节镜下关节腔清理术治疗痛风性膝关节炎,能显著降低患者术后疼痛程度,提高膝关节功能和生活质量。     

药物注射联合关节镜清理术对膝骨性关节炎患者血清炎症因子及疗效的影响

目的探究药物注射联合关节镜清理术对膝骨性关节炎(KOA)患者血清炎症因子及疗效的影响。方法将2014年1月～2016年1月入院的120例KOA患者采用随机数字表分为研究组和对照组,每组60例。两组均实施关节镜清理术,研究组增加关节腔内玻璃酸钠、得宝松及罗哌卡因注射。对比治疗前后两组患者血清炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,记录治疗5周后膝关节疼痛状况[视觉模拟评分(VAS评分)],并随访1年以评估关节功能[膝骨性关节炎治疗效果评定标准(JOA评分)]和临床疗效。结果治疗5周后,两组的CRP、IL-6、TNF-α水平均较治疗前下降(P<0.05或0.01),且研究组降幅大于对照组(P<0.01)。随访1年后,研究组的临床优良率高于对照组,差异有统计学意义(P<0.05)。随访1年时,两组JOA评分均较治疗前上升(P<0.05),研究组增幅大于对照组(P<0.05)。结论关节镜清理术联合药物注射能提升KOA治疗效果,有利于关节功能恢复、降低患者炎症因子水平。     

桂枝芍药知母汤治疗对膝骨关节炎关节镜清理术患者术后疼痛、功能恢复及血清学指标的影响

目的研讨桂枝芍药知母汤治疗对膝骨关节炎(KOA)关节镜清理术患者术后疼痛、功能恢复及血清学指标的影响。方法选取2020年8月至2022年10月入住我院行关节镜清理术治疗的KOA患者86例,按照随机数表法分组,每组43例。对照组术后予以常规治疗,观察组在此基础上予以桂枝芍药知母汤治疗,疗程7d。比较两组治疗前后阶段的疼痛程度[可视模拟评分法(VAS)]、膝关节功能恢复(Lysholm评分)以及血清学指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]。结果治疗后第1、3、5及7d,观察组VAS测评结果均低于对照组,差异有统计学意义(P<0.05)。观察组治疗后第3、5及7d的Lysholm测评结果均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组3项血清学指标(IL-6、TNF-α及hs-CRP)检测值均低于对照组,差异有统计学意义(P<0.05)。结论桂枝芍药知母汤用于KOA关节镜清理术患者的辅助治疗效果显著,可减轻术后疼痛,促进膝关节功能恢复,或与其能够减轻机体炎性反应的机制有关。     

Bone joint

<正>210177 Establishment of prosthesis-related infection model after total knee arthroplasty in rabbits/Wang Zhichou(王志酬,Dept Orthop Surg,1st Teaching Hosp Xinjiang Med Univ,Urumqi 830054)…Chin J Exp Surg.-2010,27(2).-258～260Objective An animal model was developed to test the efficacy of innovative therapies for the prevention of     

Bone joint

The anatomical and clinical research of the meniscofemoral ligaments;Postoperative evaluation of tunnel position by radiography in double-bundle anterior cruciate ligament reconstruction： correlation with clinical resalts;Perioperative management in Hemophilic arthropathy;Treatment of posttraumatic tibiotalar and talocalcaneal arthritis with tibiotalocalcaneal arthrodesis plus retrograde intramedullary nail.     

Bone joint

Patella reshaping versus resurfacing in total knee arthroplasty： a prospective randomized study; Arthroscopic reconstruction of anterior cruci. ate ligament using hamstring tendon graft and bioab- sorbable Rigidfix cross pins fixation;     

Bone joint

Diagnosis and arthroscopic treatment of osteo-chondral lesions of the talus;Rotational alignment of femoral prosthesis in total knee arthroplasty;Treatment of ankle arthritis after trauma through arthroscopy： a report of 52 cases;Using patella and iliac bone grafts to repair the bone defects of the knee joint due to giant cell tumor;Treatment of comblined posterior cruciate ligament and posterolateral complex injury using inlay technique     

Bone joint

206574Arthroscopic treatment of avulsion fracture ofthe tibial intercondylar eminence/Hong Lei(洪雷,DeptSports Med,Beijing Jishuitan Hosp,Beijing 100035)…∥Chin J Orthop.-2006 ,26(8) .-513 ~516ObjectiveTo describe the arthroscopic reductionsandfixation of tibial intercondylar eminence fracture withcannulated screws.MethodsDuring February 2003 toSeptember 2005 ,40 patients were treated arthroscopicallyfor fracture of thetibial intercondylar eminence .The aver-age age was 29 .5 years (11 …     

Bone joint

Recent clinical comparison of mobile-bearing and fixed-bearing total knee arthroplasty,Comparison of initial outcomes between navigated and conventional total knee arthroplasy,Computer navigation assisted minimally invasive total knee replacement： preliminary report,Preliminary clinical report of computer assisted imaging guided TKA,Computerized navigation assisted arthroscopic anterior cruciate ligament reconstruction     

Bone joint

<正>209364 Clinical observation on the different treatments targeted at different types of radial head fracture and radial neck fracture/Zhang Yingze(张英泽,Emergency Center Traumatic Orthop,3rd Hosp Hebei Med Univ,Shijiazhuang 050051)…∥Chin J Surg.-2009,47(12).-896～898Objective To assess the effect of the different treatments targeted at different types of radial head fracture and radial neck fracture.Methods A retrospective study was performed in 87 patients from February 2006 to March 2007.Fifty(four patients with radial head fractures included 36 males and 18 females,aged from 18 to 65 years (the average age was 33);Forty of them resulted from crashing,8 from traffic injury and 6 from falling injury.According to Mason classification system,there were 15 type Ⅰ,23 type Ⅱ and 16 type Ⅲ.Thirty-three patients with radial neck fractures included 21 males and 12 females,aged from 9 to 17 years (the average age was 13),29 of them resulted from crashing,1 from traffic injury and 3 from falling injury.According to O’brien classification system,there were 8 type Ⅰ,14 type Ⅱ and 11 type Ⅲ.Type Ⅰ of radial head fractures and tadial neck fractures were immobilizated with cast,the patients with type Ⅱ of radial head fractures were treated with open reduction and micro-screw or T-trapezoid and bridge-shaped plate fixation and type Ⅲ had operations to fix with bridge-shaped locked plated and repair the broken annular ligament,or replace heads with prosthesis.All patients with type Ⅱ and type Ⅲ of radial neck fractures were treated with closed reduction by leverage and percutaneous intra-medullary nailing.Results The patients were followed up for 4-12 months (mean 7.2 months).The functional recovery degrees were evaluated with Wheeler’s evaluation system.In group of radial head fractures,the results were excellent in 26 patients,good in 20,fair in 6 and poor in 2,the excellent and good rate was 85.2%.In group of radial neck fractures,the results were excellent in 20 patients,goo     

Bone joint

<正>209213 A Meta-analysis of clinical outcome after mobile-bearing versus fixed-bearing for knee arthroplasty/Cao Li(Dept Orthop,1st Affil Hosp Xinjiang Med Univ,Urumqi 83054)…∥Chin J Orthop.-2009,29(2).-97~102Objective To evaluate the differences of clinical effects between mobile-bearing(MB)and fixed-bearing(FB)for knee arthroplasty using the method of Cochrane systematic review.Methods Randomized controlled trials(RCTs)on differences of clinical effects of MB or FB were identified from Ovid Medline,PubMed(1966-2008.6),Embase(1980-2008.6),Cochrane Central Register of Controlled Trials(2008)and CBM(1990-2008).All the proofs that demonstrated these issues as the RCTs were included.RevMan 4.2.10 software was used for Meta-analysis.Results Nine prospective RCTs had average 1-7.5 years follow-up,which involving 8 English and 1 German papers.The combined results of Meta-analysis indicated that there was statistical difference between two groups on post -operative maximum knee flexion(WMD=-1.63,95%CI[-2.51,-0.74],P=0.0003).Others indicated that there were no statistical differences with respect to knee society score(WMD=-0.25,95%CI[-1.09,0.59],P=0.56),patellar tilt(RD=0.01,95%CI[-0.02,0.03],P=0.64),radiological lucency around prostheses(RR=0.08,95%CI[0.61,1.29,P=0.52])and revisions of knees(RD=0.01,95%CI[-0.00,0.03],P=0.12).Conclusion Short and median follow-up indicated that although MB has statistical difference with FB on post-operative maximun flex degree of knee,but it only increase average 1.6°,and has no major clinical significance.Furthermore,there are also no major differences on knee society score,patellar track,radiological lucency around prostheses and revisions of knee,but MB has a risk of bearing dislocation.21 refs,6 figs,1 tab.     

Bone joint

Chinical results of total ankle replacement for ankle disorders; Severe dysfunction of knee joint at late stage after knee replacement treating knee tramna; Regulation of cadherins, by ostentropic hormones and growth factors in vitro in human osteoprogenitor eells; Effects of combined rat transforming growth factor beta-1 gene and insulin-like growth factor-1 gene cotransfection on osteoarthritis of rabbit knee joint in vivo;