关节镜下诊断与治疗膝关节骨性关节炎

The Arthroscopic Diagnosis and Treatment of Osteoarthritis of the Knee

目的 :探讨关节镜诊断膝关节骨性关节炎 (OA)的准确性及镜下关节清理术的临床疗效。方法 :1997年 4月～ 2 0 0 1年 4月我院对 6 7例 (6 9膝 )膝关节OA患者进行关节检后关节镜下关节清理术 ,随访 0 .5～ 4年。据关节镜下软骨退变程度 ,X线片改变和临床表现之间的关系及镜下关节清理术的临床疗效进行综合评估。结果 :软骨退行变的关节镜分级与临床表现呈正相关系 ,与X线退变程度符合率较低 (5 0 .5 % ) .软骨退变与疗效关系 :术后 2年内优良率 :Ⅰ度退变 10 0 % ,Ⅱ度退变 76 .4% ,Ⅲ度退变 5 1.7%。 2年以上优良率 :Ⅰ度退变 93.8% ,Ⅱ度退变 5 1.7% ,Ⅲ度退变 35 %。结论 :①关节镜检查使膝关节OA的诊断更准确、合理。

Objective: To investigate the relationship between arthroscopic diagnosis of the knee and the clinical results of arthroscopic debridement. Methods: Arthroscopic examinations and debridement were performed in 69 knee of 67 patients with Osteoarthritis(OA) of the knee between April 1997 and April 2001. All the patients were followed up for 0.5～4years. The results were evaluated comprehensively according to the degree of cartilage degenerative under Arthroscopic, X ray changes, clinical findings, and effects of debridement. Results: There was a positive correlation between arthroscopic evaluation and clinical findings. In contrast, there was not any correlation (50.5%) between X ray changes and arthroscopic findings. The relation between cartilage degenerative changes and theraputic efficacy showed that in two years the excellent theraputic rate was 100% in degreeⅠ, 76.4% in degree Ⅱ, and 51.7% in degree Ⅲ.However, in more than two years the excellent rate was 93.8% in degreeⅠ, 57.1% in degree Ⅱ,and 35% in degree Ⅲ. Conclusion:①Arthroscopic examination would make a more correct diagnosis of OA of the knee.②Arthroscopic debridement has a good clinical effect on OA of the knee