关节镜下有限清理与广泛清理术治疗膝骨性关节炎的疗效比较

Comparison of the curative effect of arthroscopic limited debridement and extensive debridement in the treatment of knee osteoarthritis

目的探讨关节镜下有限清理与广泛清理术治疗膝骨性关节炎(KOA)的疗效比较。方法选取2015年1月~2017年6月间于我院骨科住院拟行关节镜下关节清理术治疗的膝关节OA的患者74例,随机分为观察组和对照组。对照组与观察组患者分别予以关节镜下有限清理术与广泛清理术。观察并比较两组患者手术时间、术后疼痛评分、术后恢复时间及膝关节功能和临床疗效。结果观察组的手术时间、术后疼痛评分及术后恢复时间明显长于对照组(P<0.05)。手术后,两组膝关节HSS评分较前明显上升(P<0.05),且治疗后两组膝关节HSS评分比较差异无统计学意义(P>0.05);两组临床效果优良率比较差异无统计学意义(χ~2=0.14,P>0.05)。结论关节镜下有限清理术与广泛清理术治疗KOA的短期疗效相当,前者手术时间短、术后疼痛轻、术后恢复快,宜作为首选术式。

Objective To investigate and compare the efficacy of arthroscopic limited debridement and extensive de- bridement in the treatment of knee osteoarthritis （KOA）. Methods From January 2015 to June 2017, 74 hospitalized patients with knee joint OA who were given arthroscopic joint debridement in the department of orthopedics in our hos- pital were selected and randomly divided into observation group and control gToup. Patients in the control group and the observation group were given limited debridement and extensive debridement under arthroscopy. The operation time, postoperative pain score, postoperative recovery time and knee joint function were observed and compared between the two groups, and the clinical efficacy was compared. Results The operation time, postoperative pain score and postopera- tive recovery time in the observation group were significantly longer than those in the control group（P〈0.05）. After surgery, the HSS scores of knee joint in both groups were significantly increased（P〈0.05）, and there was no statistically significant difference in HSS score of knee joint between the two groups after treatment（P〉0.05）; there was no statisti cally significant difference between the two groups in the excellent and good rate of clinical effects（∽2=0.14, P〉0.05）. Conclusion The limited debridement and extensive debridement under arthroscopy in the treatment of KOA have an equivalent short-term efficacy. The former has short operation time, mild postoperative pain, and rapid postoperative recovery, which should be selected as the preferred surgical approach.