关节镜下病灶清理术治疗踝关节骨性关节炎的效果分析

Effect analysis of surgical treatment for ankle osteoarthritis under arthroscopy

目的观察关节镜下病灶清理术治疗踝关节骨性关节炎的临床效果。方法选择我科2012年1月至2014年6月收治的48例踝关节骨性关节炎患者为研究对象，所有患者均接受关节镜下病灶清理术治疗。分别采用改良McGuire踝关节评分系统、美国足踝外科AOFAS踝-后足评分以及Mazur踝关节评分系统判断术后临床效果。结果48例患者末次随访时与治疗前改良McGuire评分分别为（85.64±16.52）分与（52.46±10.25）分，AOFAS评分分别为（85.24±11.46）分与（53.68±9.48）分，Mazur评分分别为（86.45±12.57）分与（58.49±8.64）分，差异均有统计学意义（t值分别为-8.465、-7.548、-6.596，P均〈0.05）。术前轻度病变组（n＝25）与重度病变组（n＝23）改良McGuire评分分别为（62.45±7.63）分与（49.58±6.35）分，末次随访时分别为（93.68±11.54）分与（68.54±9.68）分，差异均有统计学意义（t值分别为3.685、8.695，P均〈0.05）。改良McGuire评分、AOFAS评分及Mazur评分系统判断术后临床效果的优良率分别为91.67%（44/48）、89.58%（43/48）和89.58%（43/48），差异无统计学意义（χ2＝0.824，P均〉0.05）。结论关节镜下病灶清理术治疗踝关节骨性关节炎临床效果显著，创伤小，尤其适用于病变较轻的患者，值得在临床中推广应用。

ObjectiveTo discuss the clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy.MethodsForty-eight cases with ankle osteoarthritis patients admitted at the Orthopaedic Hospital of Zhengzhou from January 2012 to June 2014 were selected and all of them were given the treatment of focal cleaning under arthroscopy.The clinical effect of surgical treatment were judged by modified McGuire ankle rating system, the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system respectively.ResultsAt the time of the last follow-up, modified McGuire ankle rating system（（85.64±16.52） points vs.（52.46±10.25） points, t=-8.465）, the United States after ankle surgery AOFAS ankle-full score [（85.24±11.46） points vs.（53.68±9.48） points, t=-7.548） and Mazur ankle rating system（（86.45±12.57） points vs.（58.49±8.64） points, t=-6.596） all increased than that of pre-operation, the differences were statistically significant（P〈0.05）. The modified McGuire ankle rating system of patients with low-grade lesion at pre-operation（（62.45±7.63） points vs.（49.58±6.35） points, t=3.685） and the time of the last follow-up（（93.68±11.54） points vs.（68.54±9.68） points, t=8.695） were all higher than that of patients with high-grade lesion, the differences were statistically significant（P〈0.05）. The clinical effect of surgical treatment judged by modified McGuire ankle rating system, the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system were respectively 91.67%（44/48）, 89.58%（43/48） and 89.58%（43/48）, the differences were no statistically significant（χ2=0.824, P〉0.05）.ConclusionThe clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy is remarkable and it causes light damage to the body.It is especially suitable for patients with low-grade lesions and is worth popularization and application.