关节镜下微骨折术联合口服盐酸氨基葡萄糖治疗早期膝骨关节炎的近期疗效

Short-term Effect of Arthroscopic Microfracture Surgery Combined with Oral Glucosamine Hydrochloride in the Treatment of Early Knee Osteoarthritis

目的探讨关节镜下微骨折术联合口服盐酸氨基葡萄糖在治疗早期膝骨关节炎的临床疗效。方法回顾性分析2007年3月-2013年8月住院治疗并获得随访的膝骨关节炎患者172例,根据治疗方法分为观察组(82例)和对照组(90例)。观察组行微骨折手术并给予口服盐酸氨基葡萄糖,对照组仅行微骨折手术。术后1、3、6、12个月各复查1次,以后每半年复查1次,如有特殊情况随时复查。根据Lysholm膝关节功能评分、国际骨关节炎Lequesne指数评分及膝关节正侧位X线片比较两组的疗效。结果两组术后随访症状均较术前明显好转。两组术前及术后1、3个月国际骨关节炎Lequesne指数评分比较差异无统计学意义(P>0.05);两组术后6、12、18、24个月国际骨关节炎Lequesne指数评分组间比较差异有统计学意义(P<0.05)。两组术前Lysholm膝关节功能评分比较差异无统计学意义(P>0.05);两组术后Lysholm膝关节功能评分均较术前明显提高,差异有统计学意义(P<0.05);两组术后1、3个月评分组间比较差异无统计学意义(P>0.05);术后6、12、18、24个月观察组评分均较对照组高,差异有统计学意义(P<0.05)。结论关节镜下微骨折手术治疗结合口服氨基葡糖糖对早期骨关节炎患者治疗有效,且随时间推移疗效更加显著。

Objective To investigate the clinical effect of arthroscopic microfracture surgery combined with oral glucosamine hydrochloride in the treatment of early knee osteoarthritis.Methods We retrospectively analyzed the clinical data of 172 patients with knee osteoarthritis treated between March 2007 and August 2013.The patients were divided into observation group（n=82） and control group（n=90） according to their treatment.Patients in the control group only underwent arthroscopic debridement and cartilage defect microfracture surgery,while those in the observation group underwent arthroscopic microfracture surgery combined with oral glucosamine hydrochloride.The Lysholm knee functional scores,the Lequesne index and X ray image were used to compare the clinical efficacy between the two groups.Results The postoperative symptoms of both the two groups were significantly alleviated.The Lequesne index was not significantly different between the two groups before surgery,and 1 and 3 months after surgery（P〉 0.05）,but it was significantly difference between the two groups 6,12,18 and 24 months after surgery（P〈 0.05）.Before surgery,the Lysholm score was not significantly different between the two groups（P〉 0.05）,and the score increased significantly after surgery in both the two groups（P〈 0.05）.One and 3 months after surgery,the Lysholm score was not significantly different between the two groups（P〉 0.05）,but it was significantly higher in the observation group 6,12,18 and 24 months after surgery.Conclusion Arthroscopic microfracture surgery combined with oral glucosamine hydrochloride is effective in treating patients with early knee osteoarthritis,and the clinical efficacy becomes more significant with the time of treatment.