射频针刀联合臭氧注射治疗对膝骨关节炎软组织张力特征影响的临床研究

目的:观察射频针刀联合臭氧注射对II级膝骨性关节炎(KOA)周围软组织张力的改善作用。方法:选择天津中医药大学第一附属医院骨伤科收治的单侧KOA患者60例,治疗组采用射频针刀联合臭氧治疗,对照组采用手法治疗,治疗前后采用疼痛VAS评分、骨关节炎WOMAC指数进行疗效评价,用软组织张力测试仪测量健患侧治疗前后膝周4个点在200×g压力时所对应的位移值(FDD值)。结果:治疗组与对照组治疗后患者VAS评分减小,WOMAC指数较治疗前改善,差异均有统计学意义(P<0.05)。治疗组VAS评分和WOMAC指数较对照组明显改善,差异有统计学意义。治疗组与对照组治疗后髌上2 cm处股内侧肌、股中间肌、股外侧肌,髌韧带中点的FDD值均较治疗前改善,差异有统计学意义(P<0.05)。结论:射频针刀联合臭氧注射与手法治疗KOA均能改善患者膝关节疼痛、功能,但在疼痛、功能改善程度以及临床疗效方面前者要优于后者。两种治疗均能对膝关节周围软组织张力产生影响,使膝关节周围软组织张力降低,改善力学微环境。

Clinical Research of Radiofrequency Needle Scalpel combined with Ozone Injection on Soft Tissue Tension Characteristics of KOA

Objective To observe the effect of the improvement of soft tissue tension around the grade II Knee Osteoarthritis (KOA) by the treatment of the radiofrequency needle scalpel combined with ozone injection. Methods Choose 60 patients with unilateral knee osteoarthritis,whose KL classification is class II. The treatment group received RF needle knife combined with ozone treatment and the control group received manual treatment.Pain VAS score and osteoarthritis WOMAC index were used to evaluate the efficacy before and after treatment.Meanwhile, soft tissue tensiometer was used to measure the displacement(FDD value) of 4 points around the knee at 200×g pressure. Results After treatment, the score of VAS in the treatment group and the control group were decreased. The WOMAC index was improved compared with that before treatment and the difference was statistically significant. The score of VAS and WOMAC index in the treatment group were significantly improved than those in the control group.After treatment, the FDD values of the medial femoris muscle,intermediate femoris muscle, lateral femoris muscle and the midpoint of the patellar ligament(2cm above the patella) in the treatment group and the control group were improved, which the difference was statistically significant. Conclusion Radiofrequency needle knife combined with ozone injection and manipulation can improve the pain and function of knee joint, but the former is better than the latter in terms of pain, function improvement and clinical efficacy. Both treatments can affect the soft tissue tension around the knee joint,reduce the soft tissue tension around the knee joint and improve the mechanical microenvironment.