关节镜下清理术联合髁间窝成形术对老年膝骨关节炎治疗效果和安全性的比较研究

目的 探讨关节镜下清理术联合髁间窝成形术对老年膝骨关节炎的治疗效果和安全性.方法 选择2012年6月至2014年12月该院收治的老年膝骨关节炎患者68例,分为A组和B组,每组34例.A组给予关节镜下清理术,B组给予关节镜下清理术联合髁间窝成形术.比较两组患者术后3个月、6个月和12个月视觉模拟评分法(VAS)评分、Lysholm评分、WOMAC评分和关节活动度,统计两组患者术后出现的不良反应事件及其发生率.结果 术后两组患者VAS评分和WOMAC评分均显著性降低(P＜0.05);与A组比较,B组患者在术后12个月VAS评分和WOMAC评分更低(P＜0.05).术后两组患者的Lysholm评分均升高(P＜0.05),B组患者在术后12个月Lysholm评分显著高于A组(P＜0.05).术后两组患者的关节活动度均得到显著改善(P＜0.05),术后6个月和12个月B组患者的膝关节活动度明显优于A组(P＜0.05).术后早期关节肿胀是两组患者出现的不良反应事件,两组比较差异无统计学意义(P＞0.05).结论 关节镜下清扫联合髁间窝成形术可以有效缓解患者关节疼痛,提高治疗效果,改善患者膝关节功能.

Comparative study of the effect and safety of arthroscopic debridement and intercondylar fossa angioplasty in the treatment of knee osteoarthritis in the elderly

Objective To compare the effect and safety of arthroscopic debridement enmbined with intercondylar fossa angioplasty in the elder with knee osteoarthritis.Methods Six-eight elderly with knee osteoarthritis were selected from June 2012 to December 2014 in this hospital and they were averagely and randomly divided into group A and B.Patients in group A were given arthroscopic debridement,while in group B were given and arthroscopic debridement,intercondylar fossa angioplasty.The levels of VAS scores,Lysholm scores,WOMAC scores and joint range of motion were measured and compared between the two groups after 3 months,6 months and 12 months of operation.The adverse events of the two groups were supervised and compared as well.Results All elder in the two groups had apparently decreasing in VAS scores and WOMAC scores (P＜0.05) after operation.Compared with group A,patients in group B had lower levels of VAS scores and WOMAC scores(P＜0.05) at 12 months after operation.The level of Lysholm score was significantly increased in the two groups after treatment(P＜0.05),while group B had a higher level at 12 months after treatment than group A (P＜0.05).The joint range of motion in the two groups were improved after treatment(P＜0.05).The elder patients in group B had better joint range of motion than group A at 6 and 12 months after operation (P＜0.05).Early postoperative swelling in the joints was the adverse event after operation,but there was no statistically difference between two groups.Conclusion The combination of arthroscopic debridement and intercondylar fossa angioplasty is effective to release knee pain,increase the clinical efficacy and improve the knee function.