关节镜清理联合髌股周围去神经化手术治疗髌股关节炎的临床疗效

Clinical effect of arthroscopic debridement combined with patellofemoral peripheral denervated operation in treating patellofemoral arthritis

目的探讨关节镜清理联合髌股周围去神经化手术治疗髌股关节炎的临床疗效。方法选取2014年1月至2015年9月该院收治的髌股关节炎膝前疼痛患者100例,采用随机数字表法将患者分为观察组和对照组,每组各50例。对照组给予关节镜清理术治疗,观察组给予关节镜清理术联合髌股周围去神经化术治疗。比较两组患者治疗前、后的视觉模拟评分(VAS)及治疗后的Lysholm和Kujala评分。结果治疗前两组患者的VAS比较差异无统计学意义(P>0.05)。治疗后两组患者的VAS均显著降低,且观察组患者的VAS低于对照组(P<0.05)。治疗后观察组、对照组患者的Lysholm评分总分分别为(80.93±4.21)、(74.29±4.48)分,观察组患者跛行、关节绞索、承受重量、疼痛、不稳定、上下楼、关节肿痛、下蹲起立的膝关节Lysholm评分均明显优于对照组(P<0.05);治疗后观察组、对照组患者的Kujala评分总分分别为(76.48±6.54)、(68.34±6.22)分,观察组患者跛行、步行距离、承受重量、下蹲、上下楼、跳跃、跑步、膝关节疼痛、长时间屈膝、髌股异常活动、膝前肿胀、膝关节曲弯受限、大腿肌肉萎缩的髌骨Kujala评分均明显优于对照组(P<0.05)。结论关节镜清理联合髌股周围去神经化手术治疗髌股关节骨关节炎能够明显缓解疼痛,改善膝关节功能和髌股关节功能。

Objective To investigate the clinical effect of arthroscopic debridement combined with patellofemoral peripheral denervated operation in treating patellofemoral arthritis.Methods One hundred cases of patellofemoral arthritis anterior knee pain in this hospital from January 2014 to September 2015 were selected and randomly divided into the observation group and control group,50 cases in each group.The control group was given the arthroscopic debridement treatment,while the observation group was given the arthroscopic debridement combined with patellofemoral peripheral denervated operation.The visual analogue scale（VAS）before and after treatment,and Lysholm and Kujala scores after treatment were compared between the two groups.Results There was no statistically significant difference in the VAS score before treatment between the two groups（P〈0.05）.After treatment,the VAS score in the two groups were significantly decreased,moreover the VAS score in the observation group was lower than that of the control group（P〈0.05）.After treatment,the Lysholm scores in the observation group and the control group were（80.93±4.21）points and（74.29±4.48）points,the knee Lysholm scores of claudication,joint noose,bearing weight,pain,instability,up and down stairs,jump,run,joint swollen and pain,squats were significantly better than those in the control group（P〉0.05）;after treatment,the Kujala total score in the observation group and the control group were（76.48±6.54）points and（68.34±6.22）points respectively,the Kujala scores of claudication,walking distance,bearing weight,squat,up and down stairs,jumping,running,knee pain,long time kneebend,abnormal patellofemoral activity,anterior knee swelling,knee bending limitation,thigh muscle atrophy in the observation group were significantly better than those in the control group（P〈0.05）.Conclusion Arthroscopic debridement combined with patellofemoral peripheral denervation surgery in the treatment of patellofemoral osteoarthritis can obviously relieve pain and improves the knee function and patellofemoral joint function.