膝骨关节病关节镜术后简易手法结合功能锻炼的临床观察

The Comparative Study of Simple Tuna Manipulation and Progressive Function Exercise for the Knee Osteoarthritis Patients after Arthroscopic Debridement

目的:观察简易拿膝手法结合渐进式功能锻炼法与单纯渐进式功能锻炼法对膝骨关节病关节镜术后患肢功能恢复的影响。方法:将2009年1月-2014年10月在我科诊断为膝骨关节病患者114例,随机分为单纯渐进性功能锻炼对照组57例和简易拿膝手法结合渐进性功能锻炼法治疗组57例,两组患者均常规进行腰麻下关节镜清扫及消融刀半月板修整及缝合,术后两组均不采用外固定方式,对照组给予渐进性功能锻炼,手法组在渐进式功能锻炼同时指导进行简易拿膝手法治疗,两组患者均于术后第3天出院,并均在术后第1,3,7,14天,2月接受患肢功能检测及膝关节WOMAC评分调查。结果:两组对比发现,治疗组术后3天即表现出疼痛明显减轻,肿胀明显消退,静息痛改善,伸膝功能及早期行走稳定状态明显提高;至术后第14天两组肿胀情况及疼痛状态逐步趋向一致,但治疗组的行走状态、上下楼梯积分及活动困难积分优于对照组。结论:简易手法结合渐进式功能锻炼对膝关节镜术后患者患肢肿胀消退及功能恢复有较大促进作用,明显优于单纯功能锻炼,其操作简单,且患者容易掌握并自行操作,值得在膝关节镜手术患者中推广。

Objeetive：To comparatively study the simple Tuna and progressive function exercise for the knee osteoarthritis patients after arthroscopic debridement. Methods.. From January 2009 to October 2014, 114 cases of knee osteoarthritis patients were randomly divided in two groups., pure progressive functional exercise control group （57 cases） and simple Tuna manipulation plus progressive function exercise group （57 eases）. All patients underwent arthroseopic debridement and meniscal-pkasty-suture. No braces were used for two groups. Patients in the control group did progressive functional exercise. The manipulation group was treated with the progressive functional exercise and knee manipulation at the same time. All patients were discharged three days after surgery. All patients got VAS score test, knee function test and WOMAC scores test at 1 day,3 days,7 days, 14 days and 2 months after surgery. Results.. In the two groups, the pain was relieved obviously after 3 days of treatment, the swelling was obviously relieved, and the rest pain improved, the knee function and the early ambulation steady state were significantly improved. 14 days after surgery, the swelling and pain of the two groups were consistent, but the treatment group was better than the control group in walking status, up and down the stairs walk scores and difficult scores. Conclusion.. Combined with manipulation, it is obviously superior to the simple functional exercise for the recovery of swelling and recovery of limb swelling in patients with knee arthroscopy. It is simple and worth to be popularized in patients with knee arthroscopy.