体外冲击波联合手法松解治疗膝关节粘连的临床研究

Clinical Study of Extracorporeal Shock Wave Combined with Manual Relaxation for Knee Joint Adhesion

目的:观察体外冲击波联合手法松解治疗膝关节粘连对关节功能恢复及疼痛的改善作用。方法:选取2017年10月至2020年10月接诊的106例膝关节粘连患者,随机数字表法分为对照组(53例,手法松解治疗)和观察组(53例,体外冲击波联合手法松解治疗)。比较两组治疗前后伸直受限角度、屈曲角度、膝关节功能、疼痛情况,比较两组治疗不良事件发生情况。结果:106例患者随访6~10个月,平均(8.14±1.57)个月,期间对照组脱落6例,观察组脱落2例。治疗前两组伸直受限角度、屈曲角度、膝关节Lysholm评分、疼痛数字评分法(NRS)评分比较,差异无统计学意义(P>0.05)。治疗后两组伸直受限角度均缩小,观察组小于对照组;屈曲角度均扩大,观察组大于对照组;膝关节Lysholm评分均升高,观察组高于对照组;NRS评分均降低,观察组低于对照组(P<0.05)。两组治疗不良事件总发生率比较,差异无统计学意义(P>0.05)。结论:体外冲击波联合手法松解治疗膝关节粘连可有效改善膝关节活动度、膝关节功能,减轻疼痛,且安全可靠。

Objective:To observe the efficacy of extracorporeal shock wave combined with manual release of knee joint adhesion on joint function recovery and pain improvement.Methods:A total of 106 patients with knee joint adhesions admitted to hospital from October 2017 to October 2020 were randomly divided into control group(53 cases,manual relaxation treatment)and observation group(53 cases,extracorporeal shock wave combined manual relaxation treatment).The extension limit angle,flexion angle,knee function,and pain of the two groups before and after treatment were compared.The occurrence of adverse events of the two groups were compared.Results:106 patients were followed up(8.14±1.57)months(6 to 10 months).During this period,6 case lose follow from the control group and 2 cases lose follow from the observation group.There was no statistically significant difference of extension restriction angle,flexion angle,knee Lysholm score,and numerical pain score(NRS)score between the two groups before treatment(P>0.05).After treatment,the extension restriction angles of the two groups were both reduced,which of the observation group was smaller than that in the control group,the flexion angles of the two groups were both enlarged,which of the observation group was larger than that in the control group,the Lysholm scores of the two groups were both increased,which of the observation group was higher than that in the control group,the NRS scores of the two groups were both decreased,which of the observation group was lower than that in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion:Extracorporeal shock wave combined with manual release to treat knee joint adhesions can effectively improve knee joint mobility,knee joint function,relieve pain,and is safe and reliable.