关节镜下有限清理术及辅助药物治疗膝关节骨性关节炎临床研究

Clinical Research on Limited Arthroscopic Debridement in Combination of Pharmacotherapy in the Treatment of Knee Osteoarthritis

目的探讨关节镜下有限清理术及辅助药物治疗膝关节骨性关节炎的临床疗效,并总结相关的治疗经验。方法 56例膝骨性关节炎患者(68膝)在关节镜诊断性检查后,行选择性的刨削增生肥厚的滑膜、修整成形磨损破裂的半月板、摘除游离体及剥脱的关节软骨、磨削症状性骨赘、修整磨损的软骨缺损区,并用大量生理盐水灌洗膝关节腔等方法结合辅助药物进行治疗。结果所有患者术后随访6～28个月,平均16个月。膝关节功能评分由术前43分增加到术后78分,优良率为82.4%。结论关节镜下有限清理术及辅助药物治疗膝关节骨性关节炎具有创伤小、恢复快、并发症低、疗效好等优点,能够缓解症状、改善关节功能、提高患者生活质量。

Objective To explore the clinical effect of limited arthroscopic debridement combined with medication in the treatment of knee osteoarthritis, and summarize the related therapeutic experience. Methods Fifty-six patients （68 knees） of knee osteoarthritis received the limited arthroscopic debridement treatment after diagnostic arthroscopy. The treatment included medication, selective planing hyperplastic and hypertrophic synovium, form truing of menisci rupture, extirpating corpus and denudate articular cartilage, grinding symptomatic osteophytes, repairing cartilage defect and continuate intra-articular lavage with saline water. Results The average follow-up period was 16 months （6 - 28 months）. The knee function score increased to postoperative 78 points from preoperative 43 points, with the excellent rate of 82.4%. Conclusion Arthroscopic debridement in combination with pharmacotherapy has the advantages of fewer traumas, quicker recovery, fewer complicationa and better curative effect in the treatment of knee osteoarthritis, which can ease symptoms, improve joint function and patients＇ quality of life.