关节镜下微骨折术修复膝关节软骨缺损

目的探讨关节镜下微骨折术修复膝关节软骨缺损的临床效果。方法选取本院2010年10月至2012年10月收治的膝关节软骨缺损患者68例,根据术式分为两组,34例患者在关节镜下采用关节清理术治疗为对照组,34例患者在关节镜下采用微骨折术治疗为观察组,术后随访6个月。两组患者治疗前后均行Tegner运动能力评分和美国特种外科医院（the hospital special surgery,HSS）膝关节功能评分,分析两组患者的临床症状改善情况、手术治疗的临床效果及术后并发症情况。结果治疗后,两组患者Tegner运动能力评分、HSS膝关节功能评分均显著升高。观察组患者Tegner运动能力评分（4.3±1.2）分,HSS膝关节功能评分（84.3±15.2）分,均明显高于对照组（2.7±0.8）分、（61.5±14.8）分,观察组患者术后疼痛病症消失情况（97.1%）,肿胀病症消失情况（100.0%）均明显好于对照组（76.5%）,（82.4%）,观察组患者手术治疗的总有效率（94.1%）明显高于对照组（73.5%）,差异均有统计学意义（P〈0.05）。观察组患者的术后并发症发生率（0）低于对照组（5.9%）,差异无统计学意义（P〉0.05）。结论关节镜下微骨折术是修复膝关节软骨缺损的有效方法,可明显改善患者的临床症状,改善膝关节功能和活动能力,提高治愈率,安全性高。

Clinical Research of Microfracture under Arthroscope in Repair of Articular Cartilage Defect

Objective To investigate clinical effect of microfracture under arthroscope in repair of articular cartilage defect.Methods 68patients with articular cartilage defect were acceptted from October 2010to October 2012.According to operation methods,patients were divided into two groups.There were 34patients treated with arthroscopic debridement in control group.There were 34patients treated with arthroscopic microfracture in observation group.Patients were followed up for 6months.Tegner motor ability score and HSS knee function score were examined in two groups before and after treatment.Complications of clinical symptoms,clinical effect and surgical treatment after operation were analyzed between two groups.Results After treatment.Tegner motor ability score and HSS knee function score increased significantly in two groups.Tegner motor ability score（4.3±1.2）points and HSS knee function score（8 4.3±1 5.2）points inobservationgroup weresignificantlyhigher thancontrolgroup（2.7±0.8）points,（6 1.5± 14.8）points.Postoperative pain disappearance（97.1%）,swelling symptoms disappearance（100%）in observation group were significantly better than control group（76.5%）,（82.4%）.Total effective rate（94.1%）in observation group was significantly higher than control group（73.5%）.Difference was statistically significant（P0.05）.Incidence of postoperative complications（0）in observation group was lower than control group（5.9%）.Difference was not statistically significant（P0.05）.Conclusion Arthroscopic microfracture surgery is an effective method to repair the articular cartilage defect of the knee,which can significantly improve patient′s clinical symptoms and improve knee function and activity,which can also improve the cure rate and has high safety.