关节镜下有限清理术治疗膝关节骨性关节炎临床效果及影响因素分析

Clinical Effect of Limited Arthroscopic Debridement in the Treatment of Knee Osteoarthritis and Analysis of Influencing Factors

目的探讨关节镜下有限清理术治疗膝关节骨性关节炎(knee osteoarthritis,KOA)临床效果及影响因素。方法选取关节镜下有限清理术治疗KOA 108例,分析性别、年龄及疾病情况等一般资料,以及临床治疗效果和膝关节疼痛、膝关节功能及Kelgren Lawrence分级等相关资料,并分析影响关节镜下有限清理术治疗KOA患者效果的相关因素。结果出院后3个月,KOA 108例中优28例,良44例,中26例,差10例,优良率为66. 67%,中差率为33. 33%。KOA 108例关节镜下有限清理术治疗后视觉模拟评分法(VAS)评分和Kellgren Lawrence分级显著降低,而Lysholm膝关节功能评分明显提高,差异均具有统计学意义(P <0. 05)。非条件单因素分析结果显示,术前不同VAS评分、Lysholm膝关节功能评分、Kellgren Lawrence分级及不同年龄、不同心理期望康复值、术后是否严格遵守并坚持锻炼与KOA患者关节镜下有限清理术治疗效果有关系。多因素Logistic回归分析结果显示,术前高VAS评分、低Lysholm膝关节功能评分、高Kellgren Lawrence分级及年龄≥60岁、高心理期望康复值均为影响KOA患者关节镜下有限清理术治疗效果的独立危险因素。结论关节镜下有限清理术治疗KOA有较好效果,但术前高VAS评分、低Lysholm膝关节功能评分、高Kellgren Lawrence分级及年龄≥60岁、高心理期望康复值为影响KOA患者关节镜下有限清理术治疗效果的独立危险因素。

Objective To investigate the clinical effect of limited debridement under arthroscopy in the treatment of knee osteoarthritis(KOA)and to analyze the related factors affecting the therapeutic effect.Methods A total of 108 patients with KOA treated by limited debridement under arthroscope were selected as the research subjects.The general data of gender,age and disease were analyzed.The clinical therapeutic effect,knee pain,knee joint function and Kelgren Lawrence grade before and after treatment were also analyzed.Related factors influencing the outcome of KOA patients treated with limited debridement were analyzed.Results Three months after discharge,for 108 cases of KOA,the results were excellent in 28 cases,good in 44 cases,fair in 26 cases and poor in 10 cases.The excellent and good rate was 66.67%,and the fair and poor rate was 33.33%.The visual analogue scale(VAS)score and Kellgren Lawrence grade of 108 KOA patients were significantly decreased after limited debridement under arthroscopy,while the Lysholm knee function score was significantly improved,suggesting significant differeces(P<0.05).The results of unconditional single-factor logistic regression model analysis showed that different VAS scores,Lysholm knee function scores,and Kellgren Lawrence grades before surgery,in addition to different ages,different psychological expectations of rehabilitation,and strict compliance with and adherence to exercise after surgery were related to the therapeutic effect of limited debridement under arthroscopy in KOA patients.Multivariate logistic regression analysis showed that preoperative high VAS score,low Lysholm knee function score,high Kellgren Lawrence grade,age of 60 and over,and high psychological expectation were independent risk factors affecting the therapeutic effect of limited debridement under arthroscopy in KOA patients.Conclusion Limited debridement under arthroscopy has a good clinical effect in the treatment of KOA,however,preoperative high VAS score,low Lysholm knee function score,high Kellgren Lawrence grade,age of 60 and over,and high psychological expectation are independent risk factors affecting the therapeutic effect of limited debridement in KOA patients.