全膝关节置换术治疗膝关节创伤性滑膜炎的临床观察

Clinical Observation of Total Knee Arthroplasty in Treatment of Traumatic Synovitis of Knee Joint

目的探讨全膝关节置换术(TKA)对膝关节创伤性滑膜炎白介素-1β(IL-1β)、膝关节功能及临床疗效的影响。方法选取攀枝花市第二人民医院于2013年4月—2016年3月收治的膝关节创伤性滑膜炎64例,按治疗方法分为观察组和对照组,每组32例。对照组给予药物加抽吸治疗,观察组采用TKA治疗。观察2组治疗前后IL-1β水平,疼痛视觉模拟评分(VAS)、膝关节KSS评分、WOMAC骨关节炎指数评分及膝关节最大屈曲角度变化情况。结果观察组治疗2周及3、6个月后,IL-1β和C-反应蛋白(CRP)水平、VAS评分、WOMAC骨关节炎指数评分低于治疗前和对照组(P<0.05),膝关节KSS评分高于治疗前和对照组,膝关节最大屈曲角度大于治疗前和对照组(P<0.05),总有效率高于对照组(P<0.05)。结论 TKA治疗膝关节创伤性滑膜炎能改善患者膝关节功能,有效降低IL-1β水平,效果较好。

Objective To investigate effects of total knee arthroplasty （TKA） on interleukin-1β （IL-1β）, knee joint function and clinical efficacy of patients with traumatic synovitis of knee joint. Methods A total of 64 patients with traumatic synovitis of knee joint admitted during April 2013 and March 2016 were divided into observation group and control group （n = 32 for each group） according to treatment methods. Control group was treated with medication and aspira- tion therapy, while observation group was treated with TKA therapy. IL-1β levels, visual analogue scales （VAS） score, knee KSS score, WOMAC osteoarthritis index score and changes of maximum flexion angle of knee joint were observed before and after treatment in two groups. Results In observation group, after treatment for 2 weeks, 3 months and 6 months, values of IL-1β and C-reactive protein （CRP） levels, VAS score and WOMAC osteoarthritis index score were significantly lower （P 〈 0. 05 ）, while knee KSS score was significantly higher, and maximum flexion angle of knee joint was larger than those before treatment and in control group （P 〈 0.05）. The total effective rate in observation group was significantly higher than that in control group （P 〈 0.05）. Conclusion TKA in treatment of patients with traumatic syn- ovitis of knee joint can improve knee function and effectively reduce IL-1β level with good effect.