关节镜辅助微创技术治疗老年膝骨关节骨创伤临床观察

Observation of clinical efficacy of arthroscopy-assisted minimally invasive technique in the treatment of elderly knee joint bone trauma

目的针对老年膝骨关节骨创伤的治疗,传统开放性手术对机体创伤性较大,而关节镜的引入为治疗带来福音,因此,本研究旨在探究关节镜辅助微创技术治疗老年膝骨关节骨创伤的临床疗效。方法选择鹤壁市鹤煤总医院2016-12-01-2018-12-01接受治疗的97例老年膝骨关节骨创伤患者作为研究对象,根据手术方法进行分组,对照组46例予以传统切开复位内固定治疗,观察组51例予以关节镜辅助微创术治疗。比较两组围手术期指标(手术时间、切口长度及术后住院时间),记录术后6个月的膝关节功能[纽约特种外科医院膝关节评分(hospital for special surgery knee score,HSS)]、膝关节疼痛[视觉模拟评分法(visual analogue scale,VAS)]改善情况和术后并发症发生情况。结果观察组手术时间为(36.29±9.04)min,低于对照组的(67.86±12.65)min,t=14.244,P<0.001;切口长度为(5.65±1.57)cm,低于对照组的(18.49±2.26)cm,t=32.754,P<0.001;术后住院时间为(8.06±2.37)d,低于对照组的(12.26±3.49)d,t=6.992,P<0.001。术后6个月,观察组患者膝关节功能优良率为92.16%,高于对照组的76.09%,χ2=4.778,P=0.029;VAS评分为(3.11±1.17)分,低于对照组的(3.95±1.51)分,t=3.079,P=0.003。观察组并发症总发生率为2.0%,低于对照组的15.2%,χ2=4.002,P=0.045。结论关节镜辅助微创技术可改善老年膝骨关节骨创伤症状,提升患者膝关节功能,且并发症轻微,安全性更高。

OBJECTIVE For the treatment of elderly knee joint bone trauma,traditional open surgery is more invasive to the body,but the introduction of arthroscopy brings good news to the treatment.This study aims to investigate the clinical efficacy of arthroscopy-assisted minimally invasive technique in the treatment of elderly knee joint bone trauma.METHODS A total of 97 elderly patients with knee joint bone trauma treated in Hemei General Hospital from December 1,2016 to December 1,2018 were selected as subjects,and the patients were grouped according to their surgical methods.46 cases in control group were treated with traditional open reduction and internal fixation,and 51 patients in observation group were treated with arthroscopy-assisted minimally invasive surgery.The perioperative indicators(surgical time,incision length,postoperative hospital stay)were compared between the two groups,and the improvements of knee joint function at 6 months after surgery[knee joint score of hospital for special surgery(HSS score)],knee joint pain at 6 months after surgery[visual analogue scale(VAS)]and occurrence of postoperative complications were recorded.RESULTS The operation time of the observation group was(36.29±9.04)min,which was lower than the(67.86±12.65)min of the control group,t=14.244,P<0.001.The incision length of the observation group was(5.65±1.57)cm,which was lower than that of the control group(18.49±2.26)cm,t=32.754,P<0.001.The postoperative hospital stay of the observation group was(8.06±2.37)d,which was lower than that of the control group(12.26±3.49)d,t=6.992,P<0.001.At 6 months after surgery,the excellent and good rate of knee joint function in observation group was significantly higher than that in control group(92.16%vs 76.09%)(χ~2=4.778,P=0.029).At 6 months after surgery,the VAS score in observation group was significantly lower than that in the control group[(3.11±1.17)points vs(3.95±1.51)points](t=3.079,P=0.003).The total incidence rate of related complications in observation group was significantly lower than that in control group(2.0%vs 15.2%)(χ~2=4.002,P=0.045).CONCLUSION Arthroscopy-assisted minimally invasive technique can significantly improve the symptoms of elderly knee joint bone trauma,and enhance the knee joint function,with mild complications and high safety.