关节镜下清理术联合钻孔减压术治疗膝关节骨性关节炎疗效观察

Arthroscopic debridement combined with drilling decompression for treatment of osteoarthrosis of knee

目的观察关节镜下清理术联合钻孔减压术治疗膝关节骨性关节炎的临床疗效。方法选择2014年12月至2015年12月郑州大学附属郑州中心医院收治的膝关节骨性关节炎患者92例,根据治疗方法将患者分为对照组和观察组,每组46例。对照组患者应用关节镜下清理术治疗,观察组患者采用关节镜下清理术联合钻孔减压术治疗。应用视觉模拟评分法(VAS)对2组患者治疗前后活动和休息时膝关节的疼痛进行评分;纽约特种外科医院(HSS)膝关节评分法对2组患者治疗前后的膝关节功能进行评分;比较2组患者治疗后的临床疗效。结果观察组患者治疗显效21例,有效23例,无效2例,总有效率95.7%(44/46);对照组患者治疗显效16例,有效18例,无效12例,总有效率76.9%(34/46);观察组患者治疗总有效率显著高于对照组(P<0.05)。2组患者治疗后膝关节活动和休息时疼痛评分均较治疗前显著降低,膝关节功能评分显著升高(P<0.05),且观察组患者治疗后膝关节活动和休息时疼痛评分较对照组降低更显著,膝关节功能评分升高更显著(P<0.05)。结论关节镜下清理术联合钻孔减压术治疗膝关节骨性关节炎具有良好的临床疗效,可改善患者的行走功能,减轻疼痛。

Objective To observe the curative effect of arthroscopic debridement combined with drilling decompression for treatment of osteoarthrosis of knee.Methods Ninety-two patients with osteoarthrosis of knee were chosen in Zhengzhou Central Hospital Affiliated to Zhengzhou University from December 2014 to December 2015.The patients were divided into control group （n =46） and observation group （n =46） according to the treatment methods.The patients in the control group were given arthroscopic debridement;based on this,the patients in the observation group were given drilling decompression treatment.The degree of knee joint pain was evaluated at activity and rest by visual analogue scales （VAS） before and after treatment in the two groups.The knee joint function of patients was evaluated by Hospital for Special Surgery（HSS） knee scoring method before and after treatment in the two groups.The clinical curative effect was compared between the two groups.Results In the observation group,21 patients were excellent,23 patients were effective,2 patients were ineffective;in the control group,21 patients were excellent,18 patients were effective,12 patients were ineffective.The total effective rate of patients in the observation group and control group was 95.7% （44/46）and 76.9% （34/46）respectively;the total effective rate of patients in the observation group was significandy higher than that in the control group（P 〈 0.05）.The pain score of knee joint at activity and rest of patients after treatment was significantly lower than that before treatment in the two groups （P 〈 0.05）;and the score of knee joint function of patients after treatment was significantly higher than that before treatment in the two groups （P 〈 0.05）.After treatment,the pain score of knee joint at activity and rest of patients in the observation group was significantly lower than that in the control group（P 〈 0.05）;the score of knee joint function of patients in the observation group was significantly higher than that in the control group （P 〈 0.05）.Conclusion Arthroscopic debridement combined with drilling decompression has good curative effect in the treatment of osteoarthrosis of knee;it can improve the walking function of patients,and relieve the pain of patients.