关节镜治疗中老年膝关节骨关节炎合并腘窝囊肿的有效性及对关节功能的影响

Effectiveness of arthroscopic treatment of knee osteoarthritis combined with popliteal cyst in middle-aged and elderly patients and its effect on joint function

目的评估关节镜应用在中老年膝关节骨关节炎(KOA)合并腘窝囊肿(PFC)治疗中的有效性及对关节功能的影响。方法选取2019年1月至2022年6月南京市浦口区中医院骨科的60例中老年KOA合并PFC患者作为研究对象,按照随机数字表法分为对照组(30例)和观察组(30例)。对照组行开放手术,观察组行关节镜手术,比较两组患者的Lysholm膝关节功能评价量表(Lysholm评分)、手术创伤指标、临床指标、术后并发症、囊肿复发率、0级恢复率。结果术前,两组患者Lysholm评分、手术创伤指标[肌酸激酶(CK)、皮质醇(Cor)、白细胞介素-1β(IL-1β)]比较,差异无统计学意义(P>0.05);术后,观察组Lysholm评分高于对照组,手术创伤指标(CK、Cor、IL-1β)、术后24 h的疼痛评分、并发症发生率、囊肿复发率低于对照组,切口长度小于对照组,住院时间、手术时间、下床活动时间短于对照组,术中出血量少于对照组,0级恢复率高于对照组,差异有统计学意义(P<0.05)。结论对中老年KOA合并PFC患者实施关节镜治疗,能够改善关节功能,提高0级恢复率,降低囊肿复发率,加之手术创伤小、并发症少、康复时间短,值得推广。

Objective To evaluate the effectiveness of arthroscopy in the treatment of knee osteoarthritis(KOA)complicated with popliteal cyst(PFC)in middle-aged and elderly patients and its effect on joint function.Methods A total of 60 middle-aged and elderly patients with KOA complicated with PFC in Department of Orthopedics of Pukou District Hospital of Traditional Chinese Medicine from January 2019 to June 2022 were selected as research objects,and they were divided into control group(30 cases)and observation group(30 cases)according to random number table method.The control group received open surgery,and the observation group received arthroscopic surgery.The Lysholm knee function evaluation scale(Lysholm score),surgical trauma indexes,clinical indexes,postoperative complications,recurrence rate of cyst,grade 0 recovery rate of the two groups were compared.Results Before operation,there were no statistically significances in Lysholm scores and surgical trauma indicators(creatine kinase[CK],cortisol[Cor],interleukin-1β[IL-1β])(P>0.05).After operation,the Lysholm score of the observation group was higher than that of the control group,the surgical trauma index(CK,Cor,IL-1β),the pain score,the complication rate,the recurrence rate of cyst 24 h after operation were lower than those of the control group,the incision length was lower than that of the control group,the length of hospital stay,the operation time,the time of getting out of bed were shorter than those of the control group,and the intraoperative blood loss was lower than that of the control group,the recovery rate of grade 0 was higher than that of control group,the differences were statistically significant(P<0.05).Conclusion Arthroscopic treatment for middle-aged and elderly patients with KOA complicated with PFC can improve joint function,increase grade 0 recovery rate,reduce the recurrence rate of cyst,reduce surgical trauma,complications,and recovery time,it is worthy of promotion.