关节镜下内侧半月板成形术联合内侧副韧带松解术对膝骨关节炎的疗效研究

Curative Effect of Arthroscopic Medial Meniscus Plasty Combined with Medial Collateral Ligament Release for Knee Osteoarthritis

目的:探讨关节镜下内侧半月板成形术联合内侧副韧带松解术对膝骨关节炎的近期疗效。方法:将64例膝骨关节炎患者随机分为治疗组和对照组,每组32例。治疗组采用关节镜下内侧半月板成形术联合内侧副韧带松解术治疗,对照组仅给予内侧半月板成形术,术后均配合功能锻炼。观察术前及术后3个月、术后1年随访时视觉模拟评分法(VAS)评分、Lysholm评分、股胫角(FTA)评分、Kellgren-Laerence(K-L)分级,比较临床疗效。结果:64例患者术后刀口愈合良好,膝关节均未发生血肿。治疗后,2组VAS评分、Lysholm评分与治疗前比较,差异均有统计学意义(P <0.05);治疗后3个月及1年,2组VAS评分、Lysholm评分比较,差异均有统计学意义(P <0.05)。2组K-L分级比较,差异有统计学意义(P <0.05)。治疗后3个月,FTA评分与治疗前比较,治疗组差异有统计学意义(P <0.05),对照组差异无统计学意义(P> 0.05);治疗后1年,FTA评分与治疗前比较,2组差异均有统计学意义(P <0.05);治疗后3个月及1年,2组FTA评分比较,差异有统计学意义(P <0.05)。结论:关节镜下内侧半月板成形术联合内侧副韧带松解术松解挛缩的内侧软组织,对缓解膝关节疼痛,提高关节活动度有重要意义。

Objective：To investigate the short-term effect of arthroscopic medial meniscus plasty combined with medial collateral ligament release on knee osteoarthritis（KOA）.Methods：Sixty-four patients with KOA were randomly divided into a treatment group and a control group,32 cases in each group.The treatment group was treated with arthroscopic medial meniscus plasty combined with medial collateral ligament release,while the control group was treated with medial meniscus plasty only,and all the patients in both groups were given functional exercise after operation.Before operation,3 months and 1 year after operation,Visual analogue scale（VAS）,Lysholm score,femoral-tibial angle（FTA）score and Kellgren-Laerence（K-L）score were observed and the clinical effects were compared.Results：Sixty-four patients recovered well after operation,and no hematoma occurred in the knee joint.After treatment,the difference respectively between VAS scores and Lysholm scores of the two groups were statistically different from those before treatment（P 〈 0.05）.Three months and one year after treatment,the differences of VAS and Lysholm scores between the two groups were statistically different（P 〈 0.05）.The differences of K-L grading in both groups were statistically signifcant（P 〈 0.05）.Three months after treatment,the difference of FTA score was signifcantly different from that before treatment in the treatment group（P 〈 0.05）,but there was no signifcant difference in the control group（P 〉 0.05）.One year after treatment,the FTA score was statistically different from that before treatment in the two groups（P 〈 0.05）.Three months and one year after treatment,there was a statistical difference between the two groups.Conclusion：Arthroscopic medial meniscus plasty combined with medial collateral ligament release is of great signifcance in relieving knee pain and improving joint mobility.