后表线松解联合皮肤牵引治疗膝骨关节炎合并轻度屈曲挛缩畸形30例临床观察

Clinical Observation on the Treatment of 30 Cases of Knee Osteoarthritis with Mild Flexion Contracture Deformity by Posterior Surface Release Combined with Skin Traction

目的:观察后表线手法松解联合皮肤牵引治疗膝骨关节炎合并轻度屈曲挛缩畸形的临床疗效和安全性。方法:将60例合并轻度挛缩畸形的膝骨关节炎患者按照随机数字表法分为治疗组和对照组,每组30例。治疗组隔日进行后表线手法松解联合皮肤牵引;对照组仅进行皮肤牵引。2组均以3周为1个疗程。观察2组临床疗效,以及治疗前、治疗后、治疗后3个月视觉模拟评分法(VAS)评分、膝关节伸直角度、西安大略和麦克马斯特大学(WOMAC)评分;记录治疗过程中的不良事件。结果:所有患者均获得随访,随访时间为3~6个月,平均(3.71±1.04)个月。治疗后,治疗组总有效率为93.33%,对照组总有效率为86.67%,2组比较,差异无统计学意义(P>0.05)。2组VAS评分、WOMAC评分、膝关节伸直角度较治疗前均有改善(P<0.05),且治疗组膝关节屈曲挛缩较对照组改善显著,差异有统计学意义(P<0.05)。治疗后3个月,治疗组总有效率为90.00%,对照组总有效率为73.33%,2组比较,差异有统计学意义(P<0.05)。2组VAS评分、WOMAC评分、膝关节伸直角度较治疗前均有改善(P<0.05),且治疗组优于对照组,差异有统计学意义(P<0.05)。治疗过程中2组均无不良事件发生。结论:后表线松解联合皮肤牵引治疗膝骨关节炎合并轻度屈曲挛缩畸形,安全有效,值得临床推广。

Objective:To observe the efficacy and safety of posterior surface release combined with skin traction in the treatment of knee osteoarthritis with mild flexion contracture deformity.Methods:Sixty cases of knee osteoarthritis with mild contracture deformity were randomly divided into a treatment group and a control group,30 cases in each.The treatment group was treated with manual release of posterior surface line and skin traction every other day,while the control group was only given skin traction.The course of treatment was three weeks for both groups.The clinical efficacy,VAS score,knee extension angle,WOMAC score before treatment,at the end of treatment and 3 months after treatment were observed,and the adverse events during treatment were recorded.Results:All patients were followed up for an average of(3.71±1.04)months(varying from 3 to 6 months).At the end of treatment,the total effective rate of the treatment group was 93.33%,and that of the control group was 86.67%.There was no significant difference between the two groups(P>0.05).VAS score,WOMAC score and knee joint extension angle of the two groups were improved compared with those before treatment(P<0.05),and the knee flexion contracture in the treatment group was more significantly improved than that in the control group(P<0.05).Three months after treatment,the total effective rate of the treatment group was 90.00%,and that of the control group was 73.33%.The difference between the two groups was statistically significant(P<0.05).VAS score,WOMAC score and knee joint extension angle of the two groups were improved compared with those before treatment(P<0.05),and the treatment group were better than those in the control group(P<0.05).No adverse events occurred in both groups during the treatment.Conclusion:It is safe and effective to treat knee osteoarthritis combined with mild flexion contracture deformity by posterior surface release combined with skin traction,which is worthy of clinical promotion.