关节镜下微骨折治疗膝骨性关节炎临床疗效研究

Clinical efficacy of treating knee osteoarthritis by microfracture under arthroscopy

目的 探讨关节镜下微骨折在治疗膝骨性关节炎的临床疗效.方法 将患者随机分为关节清理组和微骨折组,各40例.关节清理组清理骨性关节炎退变组织,包括游离体、剥脱软骨和骨赘等、髌股关节高压及髌骨活动轨迹异常者行外侧支持带松解,刨削增生的滑膜.微骨折组对软骨破坏裸露区进行磨削后打孔的微骨折技术处理.根据患者临床症状改善程度、美国特种外科医院膝关节评分（HSS膝关节评分）标准综合评定及Tegner运动评级评定治疗疗效.结果 80例均获随访,时间11～15（13.1±0.5）个月,关节清理组显效9例,有效22例,无效9例,有效率为77.5％.微骨折组显效22例,有效15例,无效3例,有效率为92.5％,两组治疗效果比较差异有统计学意义（P＜0.05）.结论 关节镜下微骨折较关节清理临床疗效更显著,是一种简便、疗效显著的治疗方法.

Objective To explore the clinical efficacy of microfracture technique in treating knee osteoarthritis under arthroscopy.Methods 80 patients with knee osteoarthritis undergoing arthroscopy were equally divided into microfracture group and debridement group.In the debridement group,the osteoarthritis degeneration,such as the floating cartilage,the exofoliative cartilage,osteophyte,was debrided under the arthoscopy.the lateral ligament was released and the synovial hyperplasia was planed in the platellofemoral hypertension or patella mal-track case.What＆#39; s more,microfractue was performed in the chondral defect area in the microfracture group.Hospital for special surgery knee score （HSS knee score system） and Tegner activity score system were implied to evaluate the knee function.Results All the patieuts had got a （13.1 ±0.5） months follow-up.In the debridement group,9 cases was excellent,22 cases was good,the effective rate was 77.5%.In the microfracture group,22 cases was excellent,15 cases was good,the effective rate was 92.5%.There was a significant difference in efficacy between the two groups.Conclusion The microfracture technique under the arthroscopy is a much more effective than the simple debridement.It is characterized by simplicity and efficacy.