关节镜下清理和钻孔治疗膝关节软骨退变的疗效分析

目的探讨关节镜下清理和钻孔治疗膝关节软骨退变的临床疗效。方法 2009年1月至2013年2月,87例膝关节软骨退变患者随机分为两组,A组含45例(56侧),予关节镜下清理术治疗;B组含42例(51侧),行关节镜下清理+软骨下骨钻孔术,术后予对症治疗。观察两组患者治疗后的效果。结果 A组治疗后6个月时优良率为64.29%,B组6个月后优良率为84.31%,差异有统计学意义(P<0.01)。两组患者术后均随访2年,B组术后6个月、1年和2年的优良率分别为89.29%、80.36%和75.00%,术后2年时的疗效显著低于6个月时(P=0.04)。结论关节镜清理+钻孔术治疗膝关节软骨退变疗效优于单纯关节镜清理术,但其疗效随时间延长而降低。

Effectiveness of Arthroscopic Debridement and Drilling in the Treatment of Knee Articular Cartilage Degeneration

Objective To investigate the effectiveness of arthroscopic debridement and drilling in the treatment of knee articular cartilage degeneration. Methods From January 2009 to February 2013, 87 eligible patients with knee joint cartilage degeneration were randomly divided into two groups. Among 87 cases, 45 patients (56 knees, Group A) underwent arthroscopic debridement, 42 patients (51 knees, Group B) underwent arthroscopic debridement plus subchondral bone drilling. And the effectiveness in two groups were observed. Results In group A, 6 months after treatment, the excellent and good rate was 64.29%, while group B was 84.31%. There was significant difference between the two groups (P<0.01). All the patients were followed up for 2 years, the excellent and good rate in B group at 6 months, 1 and 2 years after operation were 89.29%, 80.36% and 75.00% respectively, the curative effect of 2 years after operation was significantly lower than 6 months after operation (P=0.04). Conclusion The effectiveness of arthroscopic debridement plus drilling technique for the treatment of articular cartilage degeneration is better than simple arthroscopic debridement, but the effect may reduce with the time prolonging.