半月板损伤伴膝前痛关节镜下髌周电凝疗效的研究

Arthroscopic circumpatellar electrocautery for meniscus injury with anterior knee pain

目的评价对术前中重度膝前痛患者在关节镜下使用髌周电凝后的效果。方法总共纳入80名半月板损伤伴中重度膝前痛患者(术前VAS评分≥4分)随机分配到髌周电凝组和非髌周电凝组,平均随访1年。患者和评分者双盲的情况下,分别在术前、术后3个月、6个月、1年进行VAS评分和Lysholm评分。结果髌周电凝组和对照组最终分别有35例和37例患者完成全部随访,术后两组膝前痛都改善,在术后3个月、6个月、1年,电凝组的Lysholm评分和VAS评分都优于对照组,两组差异有统计学意义(P<0.05)。Lysholm评分在术后3个月升高最明显,VAS在术后3个月下降最明显。结论半月板损伤伴中重度膝前痛在关节镜下行髌周电凝有效,术后一年内改善膝前痛症状。

Objective To investigate the clinical effects of arthroscopic circumpatellar electrocautery on the treatment of meniscus injury with moderate to severe anterior knee pain. Methods A total of 80 patients were randomised into the circumpatellar electrocautery group（ the diathermy group） and the non-electrocautery group（ the control group）. The patients were assessed by Lysholm score and visual analogue scale（ VAS） for anterior knee pain pre-operatively and three months,six months and one year post-operatively. The preoperative VAS score of all the patients was higher than four points. The patients and the assessors were blinded. Results Thirty-five patients were in the diathermy group and 37 patients were in the control group. Lysholm and VAS scores of the diathetmy group were better than those of the control group in three,six, and 12 months after the surgery, and the differences were statistically significant（ P 0. 05）. The Lysholm score increased mostly while the VAS score decreased mostly in the3 rdmonth after the surgery in both groups. Conclusion As a new technique,arthroscopic circumpatellar electrocautery is effective for the meniscus injury with moderate to severe anterior knee pain.