膝关节滑膜皱襞综合征不同治疗方法的疗效分析

Three therapies for plica syndrome of knee

目的 比较膝关节滑膜皱襞综合征不同治疗方法的治疗效果。方法 选取自2007-01—2013-12诊治的膝关节滑膜皱襞综合征60例,45例单纯滑膜皱襞综合征随机分为A、B、C 3组,每组15例;合并软骨损伤的滑膜皱襞综合征15例为D组。A组采用物理治疗,配合功能训练;B组定期关节腔注射玻璃酸钠治疗;C、D组行关节镜下滑膜皱襞切除术。结果 所有患者均获得平均16（12-19）个月随访,无感染发生。A、D组末次随访时Lysholm评分与治疗前差异无统计学意义（P〉0.05）,B、C组末次随访时Lysholm评分较治疗前提高,差异有统计学意义（P〈0.01）。末次随访时,A、B、C 3组间Lysholm评分差异有统计学意义（F=4.17,P〈0.05）。采用SNK-q检验进行组间比较,B组Lysholm评分高于A组（F=4.81,P〈0.05）;C组Lysholm评分高于A组（F=3.98,P〈0.05）和B组（F=4.29,P〈0.05）。结论 膝关节滑膜皱襞综合征采用关节镜手术治疗效果最好,但合并软骨损伤者治疗效果不佳。

Objective To compare the therapeutic effect of different treatments for knee synovial plica syndrome. Methods Sixty cases of the knee synovial plica syndrome from January 2007 to December 2013 were selected. Forty five cases of simple plica syndrome were randomly divided into three groups： A, B and C group. Besides, 15 cases of plica syndrome were combined with carulage injury in group D. Different treatments were used in the four groups. Results All patients received an average of 16 （12-19）months follow-up. No infection occurred. The Lysholm score of group A and D did not have statistically significant difference after treatment （P 〉0.05）; The Lysholm score of group B and C was improved after treatment （P 〈0.01）. At the last follow-up, the difference of Lysholm score between the 3 groups A, B, C was statistically significant （F =4.17, P 〈0.05）. The Lysholm score of group B was higher than that of group A （F =4.81, P 〈0.05）; The Lysholm score of group C was higher than that of group A（F =3,98, P 〈0.05） and group B（F=4.29, P 〈0.05）. Conclusion The best therapeutic method for plica syndrome of knee is the arthroscopy, but the effectiveness of arthroscopy for the plica syndrome with cartilage injury is not good.