关节镜下髌骨去神经化处理联合微骨折术治疗髌股关节炎

目的 :探讨关节镜下髌骨去神经化联合微骨折术治疗髌股关节炎的临床疗效。方法 :自2015年5月至2018年5月治疗60例膝关节退行性髌股关节炎患者,男28例,女32例;年龄24～56(40.5±3.35)岁。其中30例行单纯关节镜检查清理术(对照组),30例行关节镜下清理、髌骨周围去神经化联合软骨锥髌股关节面微骨折处理(治疗组)。术后采用VAS、Lysholm、Kujala评分评价治疗效果。结果:所有患者术后未出现切口感染、血管神经损伤、下肢深静脉血栓等并发症。60例患者均获随访,时间7～36个月,平均12.5个月。两组患者术后4周VAS评分均改善,而且治疗组改善明显优于对照组,差异有统计学意义(P0.05)。两组患者术后末次随访时行Lysholm、Kujala评分比较,治疗组改善明显优于对照组。结论:髌骨去神经化处理联合微骨折术治疗髌股关节炎能更好地缓解疼痛,改善膝关节功能。

Arthroscopic denervation of patella combined with microfracture for patellofemoral arthritis

Objective:To explore the clinical effect of knee denervation combined with micro-fracture under arthroscope in the treatment of patellofemoral arthritis.Methods:From May 2015 to May 2018,60 patients with knee joint degenerative patellofemoral arthritis were treated,including 28 males and 32 females,aged from 24 to 56(40.5±3.35) years old. Among them,30 cases underwent arthroscopic debridement alone(control group),30 cases underwent arthroscopic debridement,peripatellar denervation combined with cartilage cone and patellofemoral articular surface microfracture treatment (treatment group). VAS,Lysholm and Kujala scores were used to evaluate the therapeutic effect.Results:No complications such as wound infection,vascular nerve injury and deep venous thrombosis occurred in all patients. The patients were followed up for 7 to 36 months with an average of 12.5 months. The VAS scores of the two groups were improved 4 weeks after operation,and the improvement of the treatment group was significantly better than that of the control group,the difference was statistically significant (P<0.05). Lysholm and Kujala scores were compared at the last follow-up of the two groups,the improvement of the treatment group was significantly better than that of the control group.Conclusion:The treatment of patellofemoral arthritis with patellar denervation combined with microfracture can better relieve pain and improve knee function.