关节镜下关节清理术诊治膝关节骨关节炎

目的 探讨关节镜下关节清理术诊治膝关节骨关节炎(OA)的经验。方法 笔者自2001年3月至2003年6月采用关节镜下关节清理术诊治膝关节骨关节炎112例(132膝)，通过镜下观察与术前临床表现、X线片、彩色多普勒诊断进行比较，并观察术后疗效。结果 术后优良率87．4％，X线片改变与镜下所见符合率为54.5％，彩色多普勒对半月板损伤有一定的提示作用。结论 关节镜手术对膝关节骨关节炎具有诊断价值高，损伤小，恢复快，中期疗效明显的特点；X线片与镜下改变符合率较低。彩色多普勒对半月板损伤和关节积液有诊断价值；术后患者主动功能锻练对症状改善、功能恢复是非常重要的；术后12个月左右疗效最佳。

The arthroscopic debridement in the diagnosis of patients with osteoarthritis

Objective To evaluate the efficacy of the arthroscopic debridements in the diagnosis of patients with osteoarthritis(OA).Methods Arthrosopic debridements were performed on 132 knees in 112 patients with OA of the knee between March 2002 and June 2003.Arthroscopic evaluation and clinical findings,radiographic image studies and color Doppler ultrasonic examination were compared.The postoperative efficacy was evaluated.Results The excellent and good rate was 87.4%.Th rate of correlation between the radiographic changes and the arthroscopic findings was 54.5%.Color Doppler ultrasonic examination was of benefit to make a diagnosis of the injury of menisci.Conclusion Arthroscopic debrdements is an effective method for the diagnosis and treatment of OA of the knee and has the advantages of less injury,fast recovery.There is relatively less correlation between the radiographic changes and the arthroscoic findings.Color Doppler ultrasonic examination is of benefit to make a definite diagnosis of the injury of menisci and hydrathrosis.Voluntary activity is very important for improving the symptoms and functional recoveries.The clinical efficacy is best at 1 year postoperatively.