关节镜下关节清理加灌洗治疗慢性膝关节骨性关节炎的疗效分析

目的探讨分析关节镜下关节清理加灌洗治疗慢性膝关节骨性关节炎的疗效。方法选取2005年10月-2012年10月宁波市医疗中心李惠利医院收治的慢性膝关节骨关节炎患者82例，采用选择性、有限化关节镜下关节清理加灌洗治疗。手术包括退变软骨修整成形，修整关节面切除增生肥厚的滑膜组织，取出游离体，修整或切除退变的半月板，髁间窝成形等。所有患者均门诊定期复查随访，采用膝关节综合评分表、Lysholm评分系统2种方式评估临床疗效。结果82例患者得到6～24个月的术后随访，平均随访15．8个月。按膝关节综合评分表进行评分，术后1个月、6个月、24个月优良率分别为84．15％（69／82例）、86．21％（50／58例）、76．67％（23／30例）；按Lysholm评分系统进行评分，术前、术后1个月、6个月、24个月评分分别为（44．51±3．62）分、（88．34±4．22）分、（84．90±7．13）分、（80．64±6．75）分，术后1、6、24个月评分分别与术前相比明显升高，差异有统计学意义（P〈0．05）。结论关节镜下关节清理同时加灌洗治疗慢性膝关节骨性关节炎，可有效缓解患者临床症状，明显改善膝关节功能，具有良好疗效。

The curative effect analysis of joints under arthroscopy cleaning and lavage treatment chronic knee osteoart

Objective To explore the Curative effect of cleaning joints under arthroscopy and lavage treatment the of chro- nic knee osteoarthritis. Methods Choose 82 cases with chronic knee osteoarthritis treated from October 2005 to October 2012 in our hospital, and use selective and limited joints under arthroscopy cleaning and lavage treatment. The surgery included degeneration of cartilage repair forming and repairing articular surface to remove proliferous hypertrophy synovial tissue, removing loose bodies, Modified or remove the degraded meniscus, nest forming between naked and so on. All patients received regular postoperative follow-up review in the clinic. We used knee joint comprehensive rating scale and Lysholm rating score system to assess the clinical efficacy. Results 82 cases of patients with postoperative follow-up of 6 - 24 months ,an average follow-up was 15.8 months. According to the knee joint comprehensive rating scale, the excellent rate after 1 month,6 months,24 months were respectively 84.15% （69/82） ,86.21% （50/58） and 76.67% （23/30）. According to the Lysholm rating score system, preoperative and postoperative 1 month, 6 months, 24 months score were 44.51 ± 3.62,88.34 ± 4.22,84.9 ± 7.13,80.64 ± 6.75, postoperative 1,6,24 months＇ scores compared with preopera- tive were significantly higher, the difference was statistically significant （ P 〈 0.05 ）. Conclusion Joints under arthroscopy cleaning and lavage treatment chronic knee osteoarthritis can effectively relieve clinical symptoms, and improve the knee function significantly, at the same time this surgery had a good curative effect.