关节镜结合胫骨高位截骨术与富血小板血浆治疗膝关节炎的疗效

Efficacy of arthroscopy plus high tibial osteotomy and platelet rich plasma in osteoarthritis

目的:探讨关节镜结合胫骨高位截骨术与富血小板血浆在治疗膝关节炎中的临床应用效果。方法:选择2020年5月~2021年1月徐州市肿瘤医院收治的96例膝关节炎患者,依据随机数字表法将其分为联合组(关节镜结合胫骨高位截骨术+富血小板血浆,n=48)和对照组(关节镜结合胫骨高位截骨术+透明质酸钠,n=48)。比较两组临床疗效、术后并发症发生率及治疗前后相关指标。结果:联合组总有效率(95.83%)高于对照组(81.25%)(P<0.05);两组治疗后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、疼痛视觉模拟评分(VAS)、静息痛指数、关节压痛指数、肿胀指数、血清白介素-6(IL-6)和诱导型一氧化氮合酶(iNOS)均减少(P<0.05),lyshlom膝关节功能评分量表(LKSS)评分、膝关节活动度、膝关节内外侧间隙高度比和血清骨保护素(OPG)增加(P<0.05);且联合组相应指标的增加(减少)幅度高于对照组(P<0.05);两组患者并发症发生率差异无统计学意义(P>0.05)。结论:在关节镜结合胫骨高位截骨术后使用富血小板血浆能有效缓解膝关节炎患者术后疼痛感,减轻肿胀程度,且有助于患者膝关节功能恢复。

Objective:To investigate the clinical efficacy of arthroscopy combined with high tibial osteotomy and platelet rich plasma in the treatment of osteoarthritis.Methods:Ninety-six patients with knee arthritis treated in our hospital were included from May 2020 to January 2021,and divided into combined treatment group(arthroscopy plus high tibial osteotomy and platelet rich plasma,n=48)and control group(arthroscopy plus high tibial osteotomy and sodium hyaluronate,n=48)by random number table.The two groups were compared regarding the clinical efficacy,incidence of postoperative complications and changes of related indexes before and after the treatment.Results:The total effective rate was higher in combined treatment group(95.83%)than in the control group(81.25%)(P<0.05);After the treatment,the scoring on Western Ontario and McMaster Universities Osteoarthritis(WOMAC),visual analogue scale(VAS),resting pain index,joint tenderness index,joint swelling index,and levels of serum interleukin-6(IL-6)and inducible nitric oxide synthase(iNOS)were decreased in the two groups,whereas the scores on Lyshlom Knee Function Rating Scale(LKSS),the range of motion of the knee joint,medial and lateral knee space height and serum osteoprotectin(OPG)level were generally increased(all P<0.05),and the increase/decrease of the corresponding indexes was more obvious in the combined treatment group(P<0.05);There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Arthroscopy combined with high tibial osteotomy and platelet rich plasma can effectively relieve postoperative pain,reduce the degree of join swelling,and contribute to the recovery of knee function in patients with osteoarthritis.