关节镜技术联合改良小切口松解术治疗膝关节僵硬

Arthroscopic technique combined with modified small incision lysis for treatment of knee joint stiffness

目的探讨关节镜技术联合改良小切口松解术治疗膝关节僵硬的临床疗效。方法回顾性分析自2011-06—2017-12采用关节镜技术联合改良小切口松解术治疗的14例膝关节僵硬,采用关节镜对膝关节内粘连结构进行松解,采用改良小切口Zhao松解术完成膝关节外粘连松解。结果14例均获得随访,随访时间平均14.6(12~24)个月。随访期间所有患者肌力恢复良好,未出现感染、伸膝无力等并发症。末次随访时膝关节屈曲活动度为(106.4±19.2)°,膝关节功能Lysholm评分为(90.9±4.8)分,Barthel指数为(77.4±5.4)分,SF-36评分为(76.2±4.2)分,均较术前明显提高。末次随访时参照Judet标准评定疗效:优5例,良8例,可1例。结论关节镜技术联合改良小切口关节粘连松解术治疗膝关节僵硬可显著改善患者膝关节功能、膝关节屈曲度、日常生活能力及生活质量,但也需严格掌握手术适应证。

Objective To explore the clinical effect of arthroscopic technique combined with modified small incision joint adhesion lysis in the treatment of knee joint stiffness.MethodsThe data of 14 patients with knee joint stiffness admitted from June 2011 to December 2017 were retrospectively analyzed.Arthroscopy was used to loosen the internal adhesion structure of the knee joint,and the modified small incision Zhao lysis was used to complete the loosening of the external knee joint adhesion.ResultsAll 14 cases were followed up with an average follow-up time of 14.6(12-24)months.During the follow-up period,all patients achieved good muscle strength recovery,and there were no complications such as infection and knee extension weakness.At the last follow-up,the knee flexion range of motion was(106.4±19.2)°,the Lysholm score of knee joint function was(90.9±4.8)points,the Barthel index was(77.4±5.4)points,and the SF-36 score was(76.2±4.2)points.All of them were significantly higher than those before operation.At the last follow-up,according to Judet’s criteria,5 cases were excellent,8 cases good and 1 case fair.ConclusionArthroscopic technique combined with modified small incision joint adhesion lysis for the treatment of knee joint stiffness can significantly improve the knee joint function,knee flexion,ability of daily living and quality of life,but it also requires strict control of the surgical indications.