膝关节镜配合超短波治疗髌骨软骨软化症的临床疗效观察

To Observe the Clinical Curative Effect of Knee Arthroscopy with Ultrashort Wave in Treatment of Patella Chondromalacia

目的比较分析膝关节镜配合超短波与单纯应用膝关节镜治疗髌骨软化症的临床疗效。方法2011年3月~2015年5月,对64例髌骨软化症患者进行随机对照实验研究,随机分为两组,实验组入院后均行膝关节镜清理术,术中采用刨刀切除变性的软骨、射频修整关节面及髌骨周围去神经化,微骨折杵钻孔。术后进行14d超短波治疗,常规膝关节功能锻炼。对照组按照实验组的手术方法进行治疗,但是术后只进行常规膝关节功能锻炼。术后12个月末次随访,记录两组Lysholm评分及VAS评分。通过比较Lysholm评分和VAS评分,评估两组治疗的疗效。结果两组患者均获随访,随访12~48个月（平均26.4个月）。实验组术后Lysholm评分为（93.47±2.31）分,VAS评分为（1.28±0.46）分。对照组术后Lysholm评分为（86.94±3.44）分,VAS评分为（1.66±0.48）分。实验组与对照组相比较具有显著的统计学差异（P〈0.05）。结论膝关节镜配合超短波治疗髌骨软化症能有效改善膝关节的疼痛症状和功能,能明显延缓髌股关节炎的发展。

Objective To compare and analyse the clinical curative effect of the knee arthroscopic with ultrashort wave and simple application of knee arthroscopic in treatment of patellar chondromalacia. Methods From March2011 to May 2015,a randomized controlled trial was conducted in 64 patients with patellar chondromalacia. The patients were randomly divided into two groups,the experimental group were treated with arthroscopic debridement,intraoperative use of resection of degeneration of cartilage,the RF knife dressing joint and patellar denervation,micro fracture pestle drilling. Fourteen days after operation,the experimental group was performed ultrashort wave therapy and conventional knee joint functional exercise. The control group was treated by the operation method of the experimental group,but was only performed the routine knee joint function exercise after operation. The Lysholm score and VAS score of two groups were recorded at 12 months of postoperative follow-up,two groups of Lysholm score and VAS score. The efficacy of the two groups was evaluated by comparing the Lysholm score and VAS scores. Results The two groups were both followed up for 12 ~ 48 months（ average 26. 4 months）. After operation,in the experimental group,the Lysholm score was（ 93. 47＋ 2. 31） and the VAS score was（ 1. 28 ＋ 0. 46）. While in the control group the Lysholm score was（ 86. 94 ＋ 3. 44）,and the VAS score was（ 1. 66 ＋ 0. 48）. Compared with the control group,there was statistically significant difference between the two groups（ P〈0. 05）. Conclusion The arthroscopic cooperate with ultrashort wave in treatment of patella softening can effectively improve the knee joint pain symptoms and function,and obviously delay the development of the patellofemoral arthritis.