关节镜下微骨折术联合口服盐酸氨基葡萄糖治疗膝关节剥脱性骨软骨炎的近期疗效分析

Short-term Therapeutic Effect of Arthroscopic Microfracture Surgery Combined with Oral Glucosamine Hydrochloride on Osteochondritis Dissecans of the Knee

目的探讨关节镜下微骨折术联合口服盐酸氨基葡萄糖治疗膝关节剥脱性骨软骨炎的近期疗效。方法选取2014年1月-2015年6月收治的24例膝关节剥脱性骨软骨炎患者,按手术顺序分为单双号,单号(试验组)行关节镜下清理、微骨折术和口服盐酸氨基葡萄糖治疗,双号(对照组)行关节镜下清理和微骨折术治疗,两组术后均行下肢关节康复器康复锻炼1周后出院。术后随访6个月以上,采用Tegner膝关节运动评分标准和美国纽约特种外科医院(HSS)评分标准对两组患者术前及术后6、12、24周的膝关节功能评分并分析疗效。结果两组术后症状较术前均明显改善;膝关节功能在术后6周较术前明显改善;两组术前Tegner评分和HSS评分差异无统计学意义(P>0.05);两组患者术后第6周Tegner评分差异无统计学意义(P>0.05),术后12、24周Tegner评分差异有统计学意义(P<0.05);术后6、12、24周HSS评分,试验组较对照组明显好转,差异有统计学意义(P<0.05)。结论关节镜下微骨折术联合口服盐酸氨基葡萄糖治疗膝关节剥脱性骨软骨炎具有良好的近期疗效,优于单用关节镜下微骨折术治疗。

Objective To assess the therapeutic effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride on osteochondritis dissecans of the knee.Methods Between January 2014 and June 2015,24 patients with osteochondritis dissecans of the knee ready to undergo arthroscopic microfracture surgery were divided into experimental group（odd surgery sequence numbers） treated with arthroscopic microfracture surgery combined with oral glucosamine hydrochloride（480 mg/time,3 times per day,from the first day to 3 months after the surgery） and control group（even surgery sequence numbers） treated with arthroscopic microfracture surgery.All the patients were discharged from the hospital after one week of rehabilitation exercises with rehabilitation equipment of lower extremity.Followup lasted for at least 6 months.The therapeutic effects of the two methods were assessed according to Tegner scores for motor function of knee joint and United States New York specialty surgical hospital（HSS） scores.Results The symptoms of knee joint was alleviated significantly after the operation.The function of knee joint was improved significantly after 6 weeks.Tegner and HSS scores before surgery were not significantly different between the two groups（P〈 0.05）.The Tegner scores were not significantly different between the two groups 6 weeks after surgery（P〉 0.05）.The difference of Tegner scores were statistically significant between the two groups 12 and 24 weeks after surgery（P〈 0.05）,and HSS scores of the experimental group improved better than the control group 6,12 and 24 weeks after surgery,and the differences were statistically significant（P〈 0.05）.Conclusion The short-term effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride is better than that of arthroscopic microfracture surgery in the treatment of osteochondritis dissecans of the knee.