关节镜治疗膝关节僵硬36例疗效分析

Therapeutic effect of 36 cases of knee stiffness by arthroscopic treatment

目的探讨关节镜辅助下松解膝关节僵硬的处理方法,并观察其疗效。方法回顾性分析遵义医学院附属医院骨一科从2008年1月至2014年6月收治共36例膝关节僵硬患者,通过关节镜辅助下行关节囊内粘连松解联合股四头肌＂多点V字成型＂松解延长术,术中松解膝关节达90°,术后行规范功能锻炼,并用膝关节活动度、Lysholm评分对治疗效果进行评价。结果本组病例术后随访6~28月,平均20.5个月。术前：膝关节活动度平均伸直11.5°,屈曲29.2°,Lysholm评分平均50.2分;其中单纯行关节镜下关节囊内粘连松解14例,联合关节囊外行股四头肌＂多点V字成型＂松解延长术22例。术后：膝关节活动度平均伸直5.3°,屈曲102.6°,Lysholm评分平均92.3分。术前、术后各项指标P〈0.05,具有统计学意义。结论膝关节镜微创技术松解膝关节僵硬具有创伤小、恢复快、疗效满意的效果。

Objective To study the treatment of releasing knee stiffness by arthroscopy and observe the therapeutic effect.Methods Retrospectively analyze 36 cases of patients suffering from knee stiffness admitted by the First Department of Orthopaedics of Zunyi Medical Hospital from Jan,2008 to Jun,2014.The cases were treated with releasing of intraarticular adhesions combined with ＂Multi-point V shape ＂releasing or lengthening of quadriceps femoris.During the operation,the angle of released keen joint reached to 90°,standard functional exercises were carried out after operation and the therapeutic effect was evaluated by range of motion and Lysholm scores.Results The cases were followed-up after operation from 6 months to 28 months,on the average of 20.5months.Pre-operation：average extending angle of range of motion was 11.5°,flexion angle was 29.2°and average Lysholm score was 50.2;among the cases,7 cases were treated only with releasing of intraarticular adhesions and 29 cases were treated with releasing of intraarticular adhesions combined with ＂Multi-point V shape＂releasing or lengthening of quadriceps femoris.Post-operation：average extending angle of range of motion was5.3°,flexion angle was 102.6° and average Lysholm score was 92.3.Index before and after operation P 0.05 was with statistical significance.Conclusion Releasing knee joint stiffness by minimal invasive treatment of knee joint has the characteristics of less surgical trauma,faster convalescence and satisfactory therapeutic effect.