关节镜联合透明质酸钠治疗髌股关节炎50例

Clinical Efficacy of Arthroscopy Combined with Sodium Hyaluronate in Treating Patellofemoral Arthritis in 50 Cases

目的:探讨关节镜联合透明质酸钠(SH)对髌股关节炎(PA)患者关节液炎症因子的影响。方法:选取PA患者110例,依据治疗方法分为SH组(n=50)和对照组(n=60),对照组给予关节镜治疗,SH组在此基础上给予SH治疗,比较两组关节液炎症因子、疼痛、关节功能、并发症。结果:SH组和对照组术后关节液高敏C反应蛋白(hs-CRP)、白介素6(IL-6)水平和疼痛视觉模拟评分(VAS)显著低于术前(P<0.05),SH组术后关节液hs-CRP、IL-6水平和VAS评分分别为(8.43±0.54)mg/mL、(97.76±10.65)ng/mL、(1.23±0.41)分,显著低于对照组[分别为(10.34±1.12) mg/mL、(123.23±23.54) ng/mL、(2.19±0.62)分,P<0.05];SH组和对照组术后Lysholm膝关节评分显著高于术前(P<0.05),SH组术后Lysholm膝关节评分为(90.65±7.31)分,显著高于对照组[(83.54±7.56)分,P<0.05];SH组关节功能优良率为94.00%,显著高于对照组(80.00%,P<0.05);两组并发症发生率差异无统计学意义(4.00%、8.00%,P>0.05)。结论:关节镜联合SH治疗,可有效改善PA患者疼痛及炎症状态,有利于关节功能的恢复,且具有良好的安全性。

Objective To discuss the effect of arthroscopic debridement combined with sodium hyaluronate （SH） on the joint fluid inflammatory factor of patients with patellofemoral arthritis （PA）. Methods The patients with PA （110 cases） were selected, according to the treatment method, and they were divided into SH group （n=50 cases） and control group （n=60）. The patients in control group were treated with arthroscopic debridement, and the patients in SH group were given SH treatment on the basis of control group. The joint fluid inflammatory factors, pain, joint function, complications of the two groups were compared. Results The postoperative high sensitive C reactive protein （hs-CRP） and interleukin 6 （IL-6） levels and pain visual analogue scale （VAS） score of SH group and control group were significantly lower than those of the preoperative; the postoperative hs-CRR IL-6 levels and VAS score of SH group were （8.43 ± 0.54） mg/mL, （97.76 ± 10.65） ng/mL, （1.23 ± 0.41） scores, they were significantly lower than those of control group [（10.34 ± 1.12） mg/mL, （123.23 ± 23.54） ng/mL, （2.19 ± 0.62） scores, P〈0.05]. The postoperative knee Lysholm scores of SH group and control group were significantly higher than those of the preoperative; the postoperative knee Lysholm score of SH group was 90.65 ± 7.31, it was significantly higher than that of control group （83.54 ± 7.56, P〈0.05）. The joint function excellent rate SH group was 94.00%, it was significantly higher than that in control group （80.00%, P〈0.05）. There was no significant difference in the incidence of complications between the two groups （4.00%, 8.00%, P〉0.05）. Conclusion Arthroscopic selective debridement combined with SH con effectively improve pain and inflammation in patients with PA, and it con promote the restoration of joint function in patients, and it has a good safety, it is worth for further clinical promotion.