关节镜治疗不同严重程度膝关节骨性关节炎疗效分析

目的评价关节镜治疗不同严重程度膝关节骨性关节炎(KOA)的疗效,探讨临床关节镜使用范围。方法对采用关节镜下清创术治疗的98例(126膝)患者,依据膝骨性关节炎Lysholm评分及Kellgren-Lawrance(K-L)X线分级标准不同进行分组,对治疗前后的膝关节Lysholm评分进行回顾性分析。结果经平均(12.8±5.13)个月随访,所有患者均无关节感染、关节内血肿、深静脉血栓、关节粘连等并发症发生,K-L分级I、Ⅱ和Ⅲ级且Lysholm评分>75分者,关节镜治疗前后Lysholm评分差异有统计学意义,K-L分级Ⅲ级且Lysholm评分<60分者,关节镜治疗前后Lysholm评分差异无统计学意义。结论 K-L分级I、Ⅱ和Ⅲ级且Lysholm评分>75分者关节镜治疗效果较好,K-L分级Ⅲ级且Lysholm评分<60分者关节镜治疗疗效不满意,可以考虑行全膝关节置换术。

The treatment of different severity of the gon-osteoarthritis: an anlysis of therapeutic effects Yan Dong,Orthopedics, The First people' s hospital of xin zhou

Objective To evaluate the effect of arthroscopy in the treatment of different serverity of the gon-osteoarthritis.Methods According to the Lysholm score of gon-osteoarthritis and Kellgren-Lawrance grades of X-ray diagnosis,98 cases（126 knees）were treated by arthroscopy and divided into different groups,the scores of Lysholm assess before and after treatment were analyzed.Results During a 7 to 18 months（12.8±5.13 in average）following-up,there were significance difference of the Lysholm before and after treatment for the cases with K-L I、Ⅱ、Ⅲand Lysholm scoer 75.For the cases with K-L Ⅲ and Lysholm 60,no significance difference before and after arthroscopy treatment.Conclusion tThe cases with K-L grade Ⅰ,Ⅱ,Ⅲ,Lysholm score 75 which should be treated by arthroscopy.For the cases with K-L Ⅲ,Lysholm score 60 and K-L gradeⅣ,should be considered for total knee anhroplasty.