关节镜下清理术联合玻璃酸钠治疗膝骨性关节炎疗效新探

New exploration of arthroscopic debridement combined with sodium hyaluronate for knee osteoarthritis

目的对关节镜下清理术联合玻璃酸钠治疗膝骨关节炎（KOA）的临床有效性进行评价。方法将2013年3月~2015年3月于我院骨科收治的214例KOA患者按照手术方式不同分为对照组（106例）和治疗组（108例）,对照组行关节镜下清理术治疗,治疗组采用关节镜下清理术联合玻璃酸钠治疗。比较两组术前、术后3、6、12个月患者的膝关节功能评分（Lysholm评分）,临床有效率差异。结果两组患者治疗前Lysholm评分之间均无明显差异,术后3、6、12个月两组患者的Lysholm评分均较治疗前明显升高（P〈0.05）,治疗组术后3、6、12个月Lysholm评分均明显高于对照组（P〈0.05）。治疗组术后3、6、12个月有效率分别为80.56%、87.04%、82.41%,均明显高于对照组的67.92%、72.64%、68.87%（P〈0.05）。两组并发症发生率比较差异无统计学意义。结论关节镜下清理术联合关节腔内注射玻璃酸钠治疗KOA可以有效改善膝关节功能,近期疗效有一定优势,中远期疗效有待进一步研究。

Objective To evaluate the clinical efficacy of arthroscopic debridement combined with sodium hyaluronate for knee osteoarthritis（KOA）. Methods 214 cases of KOA patients from March 2013 to March 2015 in our hospital were assigned to control group（106 cases） and treatment group（108 cases）. Patients in control group was treated by arthroscopic debridement, and those in treatment group underwent arthroscopic debridement combined with intra-articular injection of sodium hyaluronate. The knee function scores（Lysholm score） at preoperative,3, 6, 12 months postoperation and the clinical excellent and good rates were compared between two groups. Results There were no significant differences in Lysholm scores between the two groups before operation（P〉0.05）. The Lysholm scores in the two groups after operation were significantly higher than that of before operation（P 0.05）. The Lysholm scores of the treatment group 3, 6, 12 months after operation were significantly higher than those of the control group（all P values less than 0.05）. At 3, 6, 12 months of postoperation, the excellent and good rate of the treatment group was 80.56%, 87.04%, 82.41%respectively, and was significantly higher than that of 67.92%, 72.64%, 68.87% in the control group（all P values less than 0.05）. There were no significant differences in the incidence rate of complications（P〉0.05）. Conclusion Arthroscopic debridement combined with sodium hyaluronate for KOA can significantly improve the knee function, it have certain advantages in short-term curative effect, but the clinical efficacy of med-term and long-term needs further study.