关节镜下微骨折术治疗膝关节软骨损伤的近期疗效分析

Analysis on short-term effect of arthroscopic microfracture operation on cartilage injury of knee joint

目的探讨关节镜下微骨折术对膝关节软骨损伤的近期疗效。方法研究对象选自该院2015年4月至2017年2月收治的114例膝关节软骨损伤患者,按照随机数字表法将其分成两组,每组57例。其中观察组行关节镜下微骨折术治疗,对照组行关节清理术治疗,两组术后均行康复训练,比较两组近期疗效,以及手术前后关节液内白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平变化情况。结果观察组术后总有效率为94.74%,与对照组(75.44%)比较明显上升(P<0.01)。术后3个月两组Tegner评分及HSS评分与术前相比均有明显上升(P<0.01),观察组术后3个月Tegner评分[(4.63±0.71)分]及HSS评分[(86.23±10.24)分]明显高于对照组同期(P<0.01)。术后3个月两组关节液内IL-1β、TNF-α水平与术前相比均有明显降低(P<0.01),观察组术后3个月关节液内IL-1β[(9.17±2.03)pg/mL]、TNF-α水平[(10.17±2.75)pg/mL]明显低于对照组同期(P<0.01)。观察组并发症发生率为0,与对照组(7.02%)相比明显降低(P<0.05)。结论关节镜下微骨折治疗膝关节软骨损伤,能有效降低关节液内IL-1β、TNF-α水平,近期临床疗效满意。

Objective To observe the short-term effect of arthroscopic microfracture operation in treating cartilage injury of knee joint.Methods One hundred and fourteen cases of knee joint cartilage injury treated in this hospital from April 2015 to February 2017 were selected as the research subjects and divided into the observation group and control group according to the random number table,57 cases in each group.The observation group were given arthroscopic microfracture surgery,while the control group conducted joint debridement.The two groups conducted the postoperative rehabilitation training.The short-term efficacies were compared between the two groups,and the changes of IL-1βand TNF-αlevels in the joint fluid were compared before and after the operation.Results The total effective rate in the observation group was 94.74%,which was significantly higher than 75.44%in the control group（P〈0.01）.The Tegner and HSS scores at postoperative 3 months in the two groups were significantly increased compared with those before operation（P〈0.01）.The Tegner score at postoperative 3 months in the observation group was（4.63±0.71）points and HSS score was（86.23±10.24）points,which were significantly higher than those in the control group（P〈0.01）.The levels of IL-1βand TNF-αin the joint fluid at postoperative 3 months in the two groups were significantly decreased compared with those before operation（P〈0.01）,the levels of IL-1βand TNF-αin joint fluid at postoperative 3 months in the observation group were（9.17±2.03）pg/mL and（10.17±2.75）pg/mL respectively,which were significantly lower than those in the control group（P〈0.01）.The occurrence rate of complications in the observation group was 0,which in the control group was 7.02%（4/57）,the observation group was significantly decreased compared with the control group（P〈0.05）.Conclusion The arthroscopic microfracture operation could treat cartilage injury of knee joint and effectively reduce the levels of IL-1βand TNF-αin joint fluid with satisfactory short term clinical efficacy.