关节镜下关节清理术结合功能锻炼治疗膝骨关节炎

目的探讨膝骨关节炎(KOA)患者在关节清理术后配合玻璃酸钠关节内注射及早期进行功能锻炼对膝关节功能的影响。方法 109例患者共146膝,分为A、B、C三组,A组仅进行关节镜下关节清理术、B组在关节清理术后配合关节腔玻璃酸钠注射治疗,C组关节清理术后除进行玻璃酸钠注射外,配合膝关节功能锻炼。三组患者在治疗前、治疗后2个月及6个月分别采用Lysholm评分对患者进行膝关节功能评分。结果三组患者关节疼痛程度及膝关节功能较治疗前明显改善,治疗后2个月,B、C两组Lysholm评分优于A组,B、C两组均显著优于A组,C组又优于B组,差异均有统计学意义(P<0.05);治疗后6个月,C组疗效优于A、B两组,差异具有统计学意义(P<0.05)。结论膝关节清理术后配合玻璃酸钠关节内注射及早期开展功能锻炼可以明显提高老年骨关节炎的治疗效果。

Arthroscopic Joint Debridement plus Functional Training in the Treatment of Knee Osteoarthritis

Objective To explore the effect of arthroscopic joint debridement combined with intra-articular injection of sodium hyal- uronate and functional training on patients with knee osteoarthritis （KOA）. Methods 146 knees of 109 patients were divided into 3 groups： group A, group B and group C; arthroscopic joint debridement was made to all the knees in the 3 groups while intra-articular in- jection of sodium hyaluronate was given to the knees in group B and C, and functional training was provided to the knees in group C; Lysholm score was applied in the evaluation of knee joint function of all the knees in the 3 groups before treatment, 2 months and 6 months after treatment. Results The severity of knee joint pain and knee joint function of the patients in the 3 groups were obviously im- proved after treatment ; Lysholm scores of group B and C 2 months after treatment were superior to that of group A, and the scores of group C superior to that of group B, both with statistical difference （P〈0.05）; 6 months after treatment, the effect in group C was superi- or to those in group A and B with statistical difference （P〈0.05）. Conclusions Arthroscopic joint debridement plus intra-articular injec- tion of sodium hyaluronate and functional training can obviously produce a better curative effect in the treatment of senile osteoarthritis.