膝骨性关节炎性滑膜炎的临床特征及其意义

摘要]目的 探讨膝骨性关节炎性滑膜炎在膝骨关节炎临床症状产生中的作用，了解膝关节镜下滑膜清理术的治疗效果。方法 对184例（257膝）膝关节镜术后确诊骨性关节炎患者的术前疼痛部位、影像学资料和关节镜下分型表现,及其中手术前后JOA评分进行分析。结果 所有患膝均有不同程度的疼痛症状，疼痛、检查压痛（＋）部位主要表现在膝内侧区。与此一致的是,关节镜下内侧区滑膜炎程度多较外侧区严重。通过关节镜下冲洗、滑膜切除、关节腔清理术后，JOA评分术前平均45分，术后10个月平均78分。结论 关节内侧滑膜炎是膝OA疼痛主要原因之一，关节镜下切除滑膜可以显著改善症状。

The role and mechanisms of synovitis in osteoarthritis of the knee

Objective To study the role of synovium in the development of symptoms in osteoarthritis of knee.Methods Two hundred and two knees of 184 osteoarthritis patients were studied.Pain point and radiology data were reviewed,The appearance under arthroscope and the perioperative score of JOA were assessed.Results Different degrees of pain were detected in all knees with osteoarthritis.The pain points were mainly located in the medial area.Coincidently,synonitis is generally more severe in the medial area than that of the lateral.The average score of JOA increased from 45 preoperatively to 78 operation 6 months after arthroscope.Conclusion Synonitis of the medial area of the osteoarthritis knee is one of the main causes of ache.Synovium resection relieved symptoms of the osteoarthritis knee.The free nerve endings may be implicated in the development and persistence of inflammatory synovitis and the pain pathway in osteoarthritis of the knee.