膝关节镜治疗老年性骨关节炎

Analysis of therapeutic outcomes of knee arthroscopy in treatment of osteoarthritis in aged patients

目的评估膝关节镜清理术治疗老年性骨关节炎的疗效。方法253例骨关节炎病人，年龄60岁～83岁，平均（65±4．9）岁，分为三组：A组88例行膝关节镜清理术，B组76例用关节内注射透明质酸钠，C组89例口服非甾体类抗炎药。治疗后随访18-36个月（平均26个月）。结果疗效评价采用美国膝关节协会评分进行评定。治疗前各组膝关节评分无统计学意义。A组术后1年优18．6％、良45．8％、可28，8％、差6．8％。B组1年后优9．6％、良37．6％、可35．7％、差17．1％。C组1年后优7．9％、良27．4％、可47．3％、差17．4％。A组与B、C组之间差异有统计学意义（P〈0．01）。结论关节镜清理术对老年性骨关节炎有较好的疗效。轻中度关节炎伴游离体是关节镜清理术的强指征。

Objective To assess therapeutic outcomes of arthroscopic dehridement for the treatment of osteoarthritis in aged patients. Methods Two hundred and fifty-three patients aged 60-83 （mean 65 ± 4.9） were assigned into three groups： Group A, where 88 patients received arthroscopic debridemeut; Group B, where 76 patients received intraarticular Hyalgan injection; and Group C, where 89 patients received oral NSAIDs therapy. The patients were followed up for 18-36 months （mean 26 months）. Results The results were assessed by the American Knee Society Score. There was no significant ditterence in knee score before treatment between the three groups. At one year, the outcome was excellent in 18.6% patients, good in 45.8% patients, moderate in 28.8% patients and poor in 6.8% patients in Group A, versus 9.6%, 37.6%, 35.7% and 17.1% in Group B, and 7.9%, 27.4%, 47.3% and 17.4% in Group C. The difference between Group A and B and C was significant （P〈0.01）. Conclusions Arthroscopic debridement is to some extent an eftective treatment for osteoarthritis in aged people. Mild to moderate arthritis associated with corpus liherta is a strong indication of arthroscopic debridement.