关节镜下关节清理治疗膝关节骨性关节炎的疗效观察

【目的】探讨关节镜下关节清理治疗膝关节骨性关节炎的疗效。【方法】收集98例诊断为膝关节骨性关节炎的住院患者共126膝，根据治疗方法分为两组，保守治疗62膝，其中早中期组40膝、晚期组22膝；手术治疗64膝，其中早中期组46膝、晚期组18膝。比较关节清理和保守治疗早中晚期膝关节骨性关节炎的疗效。【结果】本组中135膝，其中126膝者获得随访，随访率93．3％，随访时间为6～12个月。随访98例患者均采用Lysholm膝关节功能评分表进行随访，其中保守治疗早中期组患者与手术治疗均能取得较好疗效，但两组评分无统计学意义；晚期组患者保守治疗效果不佳，尤其在随访12个月时效果显著下降，与手术治疗患者评分有统计学差异；早中期组、晚期组手术治疗患者疗效均满意，但评分前者高于后者。【结论】关节镜下关节清理治疗不同分期膝关节骨性关节炎能达到满意效果，早中期组患者疗效更优。

Observation of the Efficacy of Arthroscopic Joint Debridement for the Treatment of Knee Osteoar-thritis

[Objective]To explore the efficacy of arthroscopic joint debridement for the treatment of knee osteoar-thritis.[Methods]A total of 1 3 5 knees of inpatients diagnosed as knee osteoarthritis were collected.According the treat-ment methods,all patients were divided into two groups.The conservative treatment group（62 knees）included early and middle stage group（40 knees）and advanced stage group（22 knees）.The surgical treatment group（64 knees）included ear-ly and middle stage group（46 knees）and advanced stage group（18 knees）.The efficacy was compared between joint de-bridement and conservation therapy for the treatment of early,middle and advance stage knee osteoarthritis.[Results]Of 1 3 5 knees,1 2 6 knees were followed up,and the follow-up rate was 9 3 .3%,and the follow-up time was 6～1 2 months. All 98 patients with the follow-up were followed up by using Lysholm knee joint function assessment table.The patients in early and middle stage group receiving conservation treatment and the patients in surgical treatment group could obtain satisfactory efficacy,but there was no significant difference in the scores between two groups（P＆gt;0.05）.The efficacy of conservative treatment of patients in advanced stage group was poor,and the efficacy was markedly decreased especially at 1 2 months of follow up.There was significant difference in the scores between patients in advanced stage group receiving conservation treatment and patients undergoing operation（P〈0.05）.The efficacy of surgical treatment in early and mid-dle stage group and advanced stage group was good,but the scores of the former were higher than those of the latter.[Conclusion]Arthroscopic joint debridement for the treatment of knee osteoarthritis can achieve satisfactory efficacy.The efficacy of patients in early and middle stage group is better.