关节镜下松解治疗TKA术后膝前痛的疗效观察

Observation on Curative Effect of Arthroscopic Release in the Treatment of Anterior Knee Pain after Total Knee Arthroplasty

目的观察关节镜下松解治疗膝关节置换(total kneearthro plasty,TKA)术后膝前痛的临床疗效。方法在我科初次单侧膝关节置换术的骨性关节炎患者中,出现膝前痛并发症者45例,分为两组:实验组20例,行关节镜下松解髌旁支持带等;对照组25例,采用保守治疗,口服药物和物理治疗;观察两组患者膝前痛的疗效。结果实验组患者膝前痛消失者17例,症状减轻者3例,未出现并发症;对照组膝前痛消失者13例,症状减轻者12例;两组比较有显著性差异。人工膝关节KSS评分,实验组关节镜术前为(50.6±12.3)分,末次随诊为(84.5±11.5)分。对照组治疗前为(54.5±12.8)分,末次随诊为(71.5±10.7)分;两组比较有显著性差异。结论关节镜下松解治疗TKA术后膝前痛手术安全,临床效果满意。

Objective To investigate the therapeutic effect of arthroscopic release in the treatment of anterior knee pain after total knee arthroplasty （TKA）. Methods 45 cases complicated with anterior knee pain after TKA were divided into two groups： 20 cases in the experimental group and 25 cases in the control group. We applied orthroscopy to check and release the lateral adhesions in the experimental group, and conservative therapy included drugs and physical therapy in the control group. Results The cure rate of anterior knee pain was 85% in the experimental group, showing significant difference from the rate of 52% in the control group. The KSS scores improved from 50.6 ±12.3 preoperatively to 84.5 ± 11.5 postperatively in the experimental group, and from 54.5 ± 12.8 preoperatively to 71.5 ± 10.7 postperatively in the control group, with significant difference between the two groups. Conclusions Arthroscopic release in the treatment of anterior knee pain after total knee arthroplasty has safe operation procedure and is satisfactory therapeutic effect.