膝关节镜下髁间窝成型术后疗效分析

The Effect of Femoral Intercondylar Fossa Plasty with Arthroscopy

目的通过对合并股骨髁间撞击症的膝关节退行性骨关节炎患者进行关节镜下髁间窝扩大成形术的疗效分析,总结髁间撞击症的膝关节镜下治疗效果。方法我科自2013年1月至2014年6月在膝关节镜下治疗膝关节骨关节炎合并股骨髁间撞击症患者60例,共72膝。其中男22例,女38例;年龄42~69岁,平均（53.6±11.2）岁。以上患膝均接受关节镜下髁间窝扩大成形手术治疗并定期随访。对患膝术前术后屈曲伸直角度、视觉模拟评分（visual analogue scale,VAS）、Lysholm评分进行评估比较,总结疗效。结果随访12~24个月,平均17.5个月。术后1年时平均伸直角度由（12.1±4.5）°变为（4.6±2.7）°,平均屈曲角度由（88.3±9.8）°增大到（93.2±8.5）°,VAS评分由（8.16±0.92）分下降至（2.43±0.56）分（P〈0.05）。Lysholm评分由（71.3±7.1）分提高到（88.6±6.5）（P〈0.05）。屈曲畸形、疼痛和功能明显改善。结论在膝关节镜下进行髁间窝扩大成形术,可以有效地改善膝关节屈曲畸形,消除疼痛,改善功能,是一种理想有效的治疗方式。

Objective To analyze the clinical effect of femoral intercondylar fossa plasty in arthroscopic examination in the treatment of knee joint arthritis combined with degenerative femoral intercondylar fossa impingement syndrome. Methods60 patients（ 72 knees） in our department（ 22 Male,38 Female,53. 6 ± 11. 2 years old） received the operations of femoral intercondylar fossa plasty during arthroscopic examination of the knee from January 2013 to June 2014. The preoperative and postoperative flexion and extention angle range,VAS scores,Lysholm scores were recorded. The effect of deformity reducing,the pain relieving and the knee function improvement was evaluated. Results The patients were followed up for an average of 17. 5months（ 12 ~ 24 months）. The average extension angle of the knee was changed as（ 4. 6 ± 2. 7） °from（ 12. 1 ± 4. 5） °,and the flexiondegree was changed to（ 9 3. 2 ± 8. 5） ° from（ 8 8. 3 ± 9. 8） °. The VAS score turned to（ 2. 4 3 ± 0. 5 6） from（ 8. 1 6 ±0. 92）（ P 〈0. 05）. The lysholm score turned to（ 88. 6 ± 6. 5） from（ 71. 3 ± 7. 1）（ P 〈0. 05）. Conclusion It can reduce deformity,relieve pain and improve the function obviously after the arthroscopy operations of the femoral intercondylar fossa plasty. The operations is an effective method.