射频辅助关节镜有限清理术治疗轻中度骨关节炎合并半月板损伤疗效影响因素分析

Influencing factors of curative effect of arthroscopic debridement assisted with radiofrequency on mild to moderate osteoarthritis combined with meniscus injury

目的探讨射频辅助关节镜有限清理术治疗轻中度骨关节炎合并半月板损伤疗效影响因素分析。方法选取2019年6月至2021年6月在上海长航医院行射频辅助关节镜有限清理术的150例轻中度骨性关节炎合并半月板损伤患者,采用随机数字表法分为观察组和对照组,每组各75例,观察组采用射频辅助关节镜有限清理术,对照组采用常规关节镜有限清理术,术后行3个月的随访,比较2组的临床疗效,于术前、术后采用美国膝关节协会评分(KSS)以及Lysholm评分评估患者膝关节功能;采用疼痛视觉模拟量表(VAS)评估患者的疼痛程度。记录2组术后并发症发生情况。观察组根据临床疗效分为优良组和中差组。收集临床相关资料,采用多因素Logistic回归分析影响其临床疗效的危险因素。结果观察组的总优良率为69.3%(52/75),高于对照组的53.3%(40/75)(P<0.05);术后,观察组的VAS评分(4.4±1.1与5.1±1.2)低于对照组,KSS(72.2±2.4与70.5±2.7)、Lysholm评分(75.2±3.2与72.4±4.1)高于对照组(P<0.05);观察组术后总并发症发生率为9.3%(7/75),低于对照组的21.3%(16/75)(P<0.05)。优良组患者的年龄<65岁、术前Kelgren Lawrence分级Ⅲ级、体质指数(BMI)≥24 kg/m2、术前Lysholm评分<60分占比均低于对照组(P<0.05)。多因素Logistic回归分析结果显示BMI、术前Lysholm评分是影响最终疗效的独立危险因素(OR值分别为1.865,1.818,P<0.05)。结论射频辅助关节镜下有限清理术可减轻患者术后疼痛,促进膝关节功能恢复,其BMI指数与术前Lyshplm评分是影响疗效的独立危险因素。

Objective To explore the influencing factors of curative effect of arthroscopic debridement assisted with radiofrequency on mild to moderate osteoarthritis combined with meniscus injury.Methods A total of 150 patients with mild to moderate osteoarthritis and meniscus injury undergoing arthroscopic debridement assisted with ra-diofrequency in our hospital were enrolled from June 2019 to June 2021.According to random number table method,they were divided into observation group(n=75) and control group(n=75).The patients in observation group were treated with arthroscopic debridement assisted with radiofrequency,while the ones in control group were treated with routine arthroscopic debridement.All the patients were followed up for 3 months after surgery.The clinical curative effect between the two groups was compared.The knee function of patients before and after surgery were evaluated by knee society score(KSS) and Lysholm score.The pain degree of patients before and after surgery were assessed by vi-sual analogue scale(VAS).The occurrence of postoperative complications in both groups were recorded.According to clinical curative effect,patients in observation group were divided into good group and poor group.The clinical related data were collected.The risk factors of clinical curative effect were analyzed by multivariate Logistic regression anal-ysis.Results The total good rate of observation group was higher than that of control group [69.3%(52/75) vs 53.3%(40/75)](P<0.05).After surgery,VAS score(4.4±1.1 vs 5.1±1.2) in observation group was lower,while KSS(72.2±2.4 vs 70.5±2.7) and Lysholm score(75.2±3.2 vs 72.4±4.1) were higher than those in control group(P<0.05).The total incidence of postoperative complications in observation group was lower than that in control group [9.3%(7/75) vs21.3%(16/75)](P<0.05).The proportions of cases with age <65 years,preoperative Kelgren Lawrence grading at gradeⅢ,body mass index(BMI) ≥24 kg/m2 and preoperative Lyshplm score <60 points in observation group were lower than those in control group(P<0.05).The results of Multivariate Logistic regression analysis showed that BMI and preoperative Lysholm score were independent risk factors of final curative effect(OR=1.865,1.818,P<0.05).Conclusion The arthroscopic debridement assisted with radiofrequency can alleviate postoperative pain and promote the recovery of knee function.BMI and preoperative Lyshplm score are independent risk factors of curative effect.