老年膝关节骨性关节炎230例临床分析

Clinical analysis of 230 cases of elderly patients with knee osteoarthritis

[背景]观察老年膝关节骨性关节炎临床功能评分、X线检查片表现及软骨退行性病变程度,并探讨三者之间的关系.[病例报告]230例老年膝关节骨性关节炎患者在术前均给行HSS功能评分及X线检查,其中190例行关节镜手术,40例行关节表面置换术,术中观察并记录软骨退行性病变程度,进行对比分析.X线检查所见、膝关节HSS功能评分与软骨退行性病变程度的诊断符合率相比较,普遍较低,但与Ⅲ度软骨退行性病变的诊断符合率相比较均较高,分别为85%,65%.[讨论]在膝关节骨性关节炎的诊断中,X线检查片及HSS功能评分均有其局限性,不能准确地反映膝关节骨性关节炎的病变程度,但对晚期骨性关节炎诊断符合率较高,将两者结合起来进行分析可能对诊断更有价值.

BACKGROUND To investigate the relationships of the clinical function scoring, the radiograph and the cartilage degeneration of the knee osteoarthritis. CASE REPORTS A retrospective survey including the HSS function scoring and X-ray examination was performed in 230 elderly patients with knee osteoarthritis. Out of 230 cases of knee osteoarthritis, 190 patients were treated with the arthroscopic operation and 40 patients were treated with the total knee arthroplasty. The cartilage degeneration was observed and recorded. The outcomes were classified by stage and compared. The coincidences rate of the radiograph and the HSS scoring with the degeneration of the knee as low, but with the third grade of the degeneration was higher, 85% and 65% respectively. DISCUSSION Both the radiograph and the HSS function scoring have limitation and can not reflect the pathological changes of the knee osteoartbritis accurately in the diagnosis of knee osteoarthritis, but the coincidence of them with the diagnosis of late stage osteoarthritis was quite high, indicating that the combination of the radiograph and the HSS function scoring will perhaps be more valuable in the diagnosis of the knee osteoarthritis.