局麻关节镜下选择性清理术治疗膝骨性关节炎的疗效

本文对260例（296个膝）膝关节骨性关节炎（OA）局麻下选择性关节镜清理术的疗效进行了总结，OA关节镜下的病理改变包括滑膜组织增生肥厚、股骨髁及髌骨应力区软骨剥脱、软骨下骨裸露和半月板磨损等，关节镜下选择性清理包括刨削增生肥厚的滑膜组织、清理关节软骨肃脱区创面和软骨碎片、切除破裂的半月板、取出体和磨削骨性阻挡。影响疗效的因素有高龄、手术适应证选择不当、关节严重退变、膝内外翻畸形力线改变等。关节镜下选择性、有限化的关节清理术创伤轻、痛苦小，可有效的缓解症状、改善功能，提高患者生活质量，延缓病程的发展。术后优良率达74.7%。

THE EFFECT OF SELECTIVE DEBRIDEMENT UNDER ARTHROSCOPY ON OSTEOARTHRITIS OF THE KNEE JOINT UNDER LOCAL ANAESTHESIA

The effect of the selective debridement with the aid of the arthroscope performed under local anesthesia for osfeoarthritis of 296 knees in 260 patients was studied. The pathological changes of osteoarthritis under the arthroscopy include hyperplasia of synovial membrane, degeneration of cartilage or exposure of subchondral bone on the stress areas of the femur condyles and patella , wear and tear of meniscus, formation of osteophyte and loose body. The debridement included the removal of the loose body, hyperplasia of synovial membrane, degenerated cartilage, and the torn meniscus. Many factors,including age of the patients, selection of the indication, stress of the knee joint, and the degeneration of cartilage,may influence the curative effect. After selecfive debridement and lavage for osteoarthritis of the knee joint, the majority of patients were released from pain, with restoration of function and range of motion, and the development of pathological process was retarded. Good and excellent results constitute 74.7% of the patients.