通过关节镜技术治疗早期膝关节化脓性关节炎

Arthroscopic treatment of knee pyarthrosis

目的 介绍关节镜技术在早期膝关节化脓性关节炎治疗中的应用,探讨其应用价值。方法 共27例早期化脓性膝关节炎的患者,在关节镜下行关节清理术,包括滑膜次全切除术,同时结合全身性抗生素的应用和术后系统的康复训练进行综合治疗。通过体温、皮温、关节积液、关节活动度以及膝关节功能的检查评价该方法的治疗效果。结果 术后平均3d,体温恢复正常;术后6周,无伸膝功能受限者,屈膝活动度均超过120。术后3个月,85.2％患者的患侧屈膝活动度恢复正常,Lysholm膝关节功能评分为（89.4±4.1）分,与术前相比差异有显著性意义（P<0.01）。结论 采用关节镜技术治疗早期膝关节化脓性关节炎创伤小、清创彻底,有利于炎症的消除和膝关节功能的恢复。

Objective To introduce a method of arthroscopie treatment of purulent knee arthritis, and to evaluate its clinical value. Methods Twenty-seven cases of knee pyarthrosis were treated by de-bridement and subtotal synovectomy under arthroscope and combined with intravenous antibiotics and systematic postoperative rehabilitation. The clinical results were evaluated through examination of the temperature, joint effusion and range of motion of the knee joint. Results The temperature resumed to normal at an average of three postoperative days. All the knees regained the normal extension and more than 120 degree of flexion at six weeks after operation. 85. 2% of the knee flexion function resumed to normal in 3 months. Lysholm knee function score was 89. 4 ± 4. 1 in average and there is a significant statistical difference ( P < 0. 01) . Conclusion Arthroscopie procedure is a minimal invasive treatment for the purulent knee arthritis and is easy to obtain thorough debridement, infection control and restoration of the knee function.