中医手法与关节镜手术治疗髌股关节病的病例对照研究

Case control study on arthroscopy and manipulation for the treatment of derangement of patellofemoral joint

目的:比较中医手法与关节镜在治疗髌股关节病中疗效的优劣。方法:将符合髌股关节病诊断的患者分成手法组和关节镜组,各31例。手法组男4例,女27例;平均年龄(52.83±5.79)岁;采用中医手法治疗。关节镜组男8例,女23例;平均年龄(54.14±6.12)岁;采用关节镜下平衡术治疗。分别比较两组治疗前、后HSS膝关节评分变化和X线片髌股关节适合角以及外侧髌股角的角度变化;同时进行两组间治疗前后评分变化和角度变化的比较。结果:两种治疗方法均可使HSS评分明显改善;治疗后手法组HSS平均(94.80±7.26)分,关节镜组平均(88.65±5.79)分,两组疗效差异无统计学意义。手法组在负重位外侧髌股关节角度的改善上较关节镜组明显。结论:两种治疗方法疗效相当,手法治疗创伤小,髌骨向外倾斜改善效果更好。

Objective：To compare the therapeutic effects of arthroscopy and manipulation of Traditional Ch inese medicine （TCM） in the treatment of patellofemoral joint disease.Methods：The patients met with the criteria of patellofemoral joint disease were divided into manipulation of TCM group and arthroscopy group randomly,31 patients in each group.There were 31 patients in manipulation of TCM group,including 4 males and 27 females,with anaverage age of （52.83±5.79）years old;and the patients were treated with manipulation.There were 31 patients in arthroscopy group,including 8 males and 23 females,with anaverage age of （54.14±6.12） years old;the patients were treated with arthroscopy.The HSS knee joint score,fitness angle of patellofemoral joint and lateral angle of patellofemoral joint in X-ray were compared in each group and between the two groups before and after treatment respectively.Results：The two therapeutics had equally efficacious in which improved HSS score significantly.After treatment,the HSS scores in manipulation of TCM group and arthroscopy group were 94.80±7.26 and 88.65±5.79 separately,the score in manipulation of TCM group was higher than that of arthroscopy group.Comparing with the arthroscopy group,lateral angle of pate llofemoral joint with weight-bearing position were improved significantly in manipulation of TCM group.Conclusion：Arthroscopy and manipulation of TCM have equally efficacious in the treatment of patellofemoral joint disease,but manipulation has advantage of minimal trauma,and is better to treat patella extraversion.