关节镜下微骨折技术联合关节内注射玻璃酸钠修复膝关节软骨缺损

目的:评价微骨折技术(microfracture,MF)联合关节内注射玻璃酸钠修复膝关节软骨缺损的修复效果.方法:对12例股骨髁软骨缺损患者采用关节镜下MF修复,缺损面积约2.0～6.0cm2,平均3.2cm2.术后第1、2、3周患膝关节腔注射玻璃酸钠20mg,1 次·周-1.术后随访,对比手术前后的膝关节Lysholm评分、痛觉视觉模拟评分(VAS),记录术后并发症.结果:术后随访6～36个月,平均17.5个月.最终随访Lysholm评分优2例、良6例、中3例、差1例,优良率为66.7%.术前Lysholm评分(46.2±3.6)分,随访终末时为(78.4±4.9)分,差异具有统计学意义(P<0.01).术前VAS为(4.26±0.56)分,终末随访时为(1.82±0.14)分,差异具有统计学意义(P<0.05).9例并发关节腔积血,2例有关节轻度疼痛和偶有交锁.结论:MF联合术后关节内注射玻璃酸钠对膝关节软骨损伤的修复效果较满意,是一种操作简单、实用的软骨修复技术.

Microfracture technique in combination with intraarticular hyaluronic acid sodium injection for the treatment of knee chondral defect under arthroscopy

Objective:To evaluate the treatment of knee chondral defect by microfracture(MF) technique in combination with intraarticular hyaluronic acid sodium injection.Methods:Twelve chondral defect patients on the femoral condyles were treated by MF under arthroscopy,with defect area 2.0-6.0 cm2,average 3.2 cm2.Postoperative 3 weeks all cases receive intraarticular injections of 20 mg hyaluronic acid sodium weekly.And the cases were followed up,the knee Lysholm scores,visual analog scores(VAS) and complications were observed.Results:All the patients were followed up for 6 to 36 months(means 17.5 months).Two cases were rated as excellent,6 as good,3 as fair and 1 poor,the excellent-good rate was 66.7% of the ultimate knee Lysholm scores.The ultimate knee Lysholm scores and VAS were significantly better than preoperative Lysholm scores(46.2±3.6) scores vs(78.4±4.9)scores,P<0.01;and VAS(4.26±0.56)scores vs(1.82±0.14)scores,P<0.05].Nine patients had hematoma in knee joint capsule,two cases had slight joint pain and clicked occasionally.Conclusion:MF in combination with intraarticular hyaluronic acid sodium injection has good effect for chondral lesion on femoral condyles,which is one kind of uncomplicated and practical method for cartilage restoration.