Effect of sodium hyaluronate combined with rehabilitation training on knee joint injury caused by golf

BACKGROUND In high-intensity sports like golf,knee joints are prone to injury,leading to pain,limited mobility,and decreased quality of life.Traditional treatment methods typically involve rehabilitation exercises,but their effectiveness may be limited.In recent years,sodium hyaluronate has emerged as a widely used biomedical material in the treatment of joint diseases.AIM To explore the effect of sodium hyaluronate combined with rehabilitation training on pain degree,flexion range of motion and motor function of knee joint injured by golf.METHODS Eighty patients with knee joint injury caused by golf were randomly divided into control(group B)and observation group(group A).The group B was treated with rehabilitation training,and the group A was treated with sodium hyaluronate combined with rehabilitation training.The clinical efficacy,range of motion and function of knee joint,quality of life and inflammatory factors were compared.RESULTS The excellent and good rate of rehabilitation in the group A was raised than group B.At 6 weeks and 3 months after treatment,the range of motion of the two groups was raised than that before treatment,and that of the group A was raised than group B.After treatment,the scores of Lysholm and International Knee Documentation Committee(IKDC)in the group A were raised,and those in the group A were raised than group B.The VAS score of the two groups was reduced than that of the group B,and the SF-36 score of the group A was reduced than group B.The interleukin(IL)-1β,IL-8 and tumor necrosis factor-αin the two groups were reduced,and those in the group A were reduced than group B.CONCLUSION Sodium hyaluronate combined with rehabilitation training has a good clinical effect in the treatment of patients with knee joint injury caused by golf,which relieve pain,maintain knee joint function and improve patients'life quality.

Multidisciplinary approach toward enhanced recovery after surgery for total knee arthroplasty improves outcomes

Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expectancies,total knee arthroplasty(TKA)is now one of the major arthroplasty surgeries performed for knee osteoarthritis.When enhanced recovery after surgery(ERAS)was introduced in TKA,clinical outcomes were enhanced and the economic burden on the healthcare system was reduced.ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response.ERAS aims to enhance the recovery phase,which encompasses multidisciplinary strategies at every step of perioperative care,including the rehabilitation phase.Implementation of ERAS in TKA aids in reducing the length of hospital stay,improving pain management,reducing perioperative complications,and enhancing patient satisfaction.Multidisciplinary collaboration,integrating the expertise of anesthesiologists,orthopedic surgeons,nursing personnel,and other healthcare professionals,is the cornerstone of ERAS in patients undergoing TKA.

Progress of improvement of pain and joint function of knee osteoarthritis treated with thunder-fire moxibustion in the last five years

Objective:To summarize the clinical research of improvement of pain and joint function of knee osteoarthritis treated with thunder-fire moxibustion in the last five years,in order to provide more objective and scientific theoretical basis for the clinical use of thunderfire moxibustion in the treatment of knee osteoarthritis.Methods:By using"thunder-fire moxibustion"and"knee osteoarthritis"as keywords,the clinical literature on the treatment of knee osteoarthritis mainly by thunder-fire moxibustion in the past 5 years in PubMed,CNKI,WF and VIP were analyzed.Results:Thunderfire moxibustion and its compound therapy,including internal use of traditional Chinese medicine,external use of traditional Chinese medicine,drug injection,physical therapy,acupuncture,heat sensitive moxibustion,pricking collaterals,acupoint application and ozone,could relieve pain,improve joint function,improve joint activity,improve patients daily life ability and have less adverse reactions.Conclusion:Thunder-fire moxibustion was a safe,non-invasive and effective treatment for knee osteoarthritis.However,further research is necessary due to the non-rigidity of the current clinical trial design.

Clinical effect of sodium hyaluronate joint cavity filling combined with exercise therapy on patients with post-traumatic knee arthritis

Objective:To research the sodium hyaluronate joint cavity filling combined with exercise therapy on the indicator of pain,motor function,and levels of inflammatory factors in joint fluid in patients with post-traumatic knee arthritis.Method Totally 100 patients(Department of Orthopaedics,The second Affiliated Hospital to Liaoning University of Chinese Medicine,2013.10-2018.8)with post-traumatic knee arthritis were selected,then they were divided into observation group(n=50)and control group(n=50).The control group was given glucosamine sulfate and sodium hyaluronate joint cavity filling,the observation group was given leg press with visual feedback,they were treated 4 weeks.Assessing the pain degree through visual analog scale(VAS),hospital for special surgery knee score(HSS)as the indicator of motor function,inflammatory factor(TNF-α,IL-6,and IL-8)in the joint fluid.Results The score of VAS were lower than pretherapy(P<0.05),the degree of VAS of observation group were lower than control group(P<0.05).The score of HSS were higher than pretherapy(P<0.05),the degree of VAS of observation group were higher than control group(P<0.05).The inflammatory factor(TNF-α,IL-6,and CRP)in the joint fluid were lower than pretherapy(P<0.05),and the observation group were lower than control group(P<0.05).Conclusions Giving sodium hyaluronate joint cavity filling combined with exercise therapy can improve the function of joint.

Effects of Denervation on the Mid-term Results of Knee Joint Functions after Non-resurfaced Total Knee Arthroplasty

Objective:Total knee arthroplasty(TKA)has become an effective treatment modality for end-stage osteoarthritis and rheumatoid arthritis.Postoperative problems such as anterior knee pain affect postoperative patient satisfaction.Patellar denervation has been proposed as a technique to relieve pain,but its efficacy remains controversial.This study evaluated the mid-and long-term effects of patellar denervation on postoperative knee joint functions,hoping to provide better guidance for clinical practice.Methods:This study is a prospective randomized controlled double-blind study.58 patients undergoing bilateral non-resurfaced total knee arthroplasty were included and randomized into two groups.Both groups underwent total knee arthroplasty while patellar denervation was performed only on the experimental group.Information regarding whether if patellar denervation was performed were withheld from all patients and outcome assessors.All surgeries were performed by the same high-level professional physician,and the post-stable knee prosthesis system(PS Scorpio NRG PS,Stryker)was used during the surgeries.The knee joint functions were evaluated by professional assessors before and after surgery.The evaluation indicators mainly include KSS scoring,Western Ontario and McMaster Universities(WOMAC)scoring and Visual Analogue Scale(VAS),FJS scoring,etc.The follow-up period was 3 years and 5 years after surgery.Results:The experimental group had better KSS and FJS scores than the control group,the difference was statistically significant.There was no significant inter-group difference in WOMAC and VAS scores.Conclusion:The patellar denervation in TKA patients has positive effects on the mid-and long-term recovery of knee joint functions,and the postoperative satisfaction is better.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Therapeutic Effect of Chinese Massage Combined with Warm Acupuncture on Knee Osteoarthritis

Objective:To investigate the effect of Chinese massage combined with warm acupuncture on knee osteoarthritis.Methods:60 patients with knee osteoarthritis who were treated in our hospital from January 2017 to October 2019 were selected as the research subjects,and they were randomly divided into 2 groups of 30 patients each.The control group was treated with oral western medicine,and the observation group was treated with massage combined with warm acupuncture.The clinical efficacy and WOMAC index were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group,and the WOMAC score was lower than that of the control group.The difference was statistically significant(P<0.05).Conclusion:Chinese massage combined with warm acupuncture is effective in treating knee osteoarthritis It can effectively alleviate the symptoms of pain and joint stiffness in patients,and improve joint mobility,which is worth for clinical promotion.

Impact of enhanced recovery pathways on safety and efficacy of hip and knee arthroplasty:A systematic review and meta-analysis

BACKGROUND Over the past decades,clinical pathways(CPs)for hip and knee arthroplasty have been strongly and continuously evolved based on scientific evidence and innovation.AIM The present systematic review,including meta-analysis,aimed to compare the safety and efficacy of enhanced recovery pathways(ERP)with regular pathways for patients with hip and/or knee arthroplasty.METHODS A literature search in healthcare databases(Embase,PubMed,Cochrane Library,CINAHL,and Web of Science)was conducted from inception up to June 2018.Relevant randomized controlled trials as well as observational studies comparing ERP,based on novel evidence,with regular or standard pathways,prescribing care as usual for hip and/or knee arthroplasty,were included.The effect of both CPs was assessed for(serious)adverse events[(S)AEs],readmission rate,length of hospital stay(LoS),clinician-derived clinical outcomes,patient reported outcome measures(PROMs),and financial benefits.If possible,a meta-analysis was performed.In case of considerable heterogeneity among studies,a qualitative analysis was performed.RESULTS Forty studies were eligible for data extraction,34 in meta-analysis and 40 in qualitative analysis.The total sample size consisted of more than 2 million patients undergoing hip or knee arthroplasty,with a mean age of 66 years and with 60%of females.The methodological quality of the included studies ranged from average to good.The ERP had lower(S)AEs[relative risk(RR):0.9,95%confidence interval(CI):0.8-1]and readmission rates(RR:0.8,95%CI:0.7-1),and reduced LoS[median days 6.5(0.3-9.5)],and showed similar or improved outcomes for functional recovery and PROMs compared to regular pathways.The analyses for readmission presented a statistically significant difference in the enhanced recovery pathway in favor of knee arthroplasties(P=0.01).ERP were reported to be cost effective,and the cost reduction varied largely between studies(€109 and$20573).The overall outcomes of all studies reported using Grading of Recommendation,Assessment,Development and Evaluation,presented moderate or high quality of evidence.CONCLUSION This study showed that implementation of ERP resulted in improved clinical and patient related outcomes compared to regular pathways in hip and knee arthroplasty,with a potential reduction of costs.

Developing an enhanced recovery after surgery program for oncology patients who undergo hip or knee reconstruction surgery

Enhanced recovery after surgery(ERAS)protocols are applied in orthopedic surgery and are intended to reduce perioperative stress by implementing combined evidence-based practices with the cooperation of various health professionals as an interdisciplinary team.ERAS pathways include pre-operative patient counselling,regional anesthesia and analgesia techniques,post-operative pain management,early mobilization and early feeding.Studies have shown improvement in the recovery of patients who followed an ERAS program after hip or knee arthroplasty,compared with those who followed a traditional care approach.ERAS protocols reduce post-operative stress,contribute to rapid recovery,shorten length of stay(LOS)without increasing the complications or readmissions,improve patient satisfaction and decrease the hospital costs.We suggest that the ERAS pathway could reduce the LOS in hospital for patients undergoing total hip replacement or total knee replacement.These programs require good organization and handling by the multidisciplinary team.ERAS programs increase patient's satisfaction due to their active participation which they experience as personalized treatment.The aim of the study was to develop an ERAS protocol for oncology patients who undergo bone reconstruction surgeries using massive endoprosthesis,with a view to improving the surgical outcomes.

Clinical effect of Rehabmtation Treating combined with Intra-Articular Injection of Sodium Hyaluronate for Exercise induced knee osteoarthritis

Objective: To study the clinical effect of rehabmtation treating combined with intra-articular injection of sodium hyaluronate for exercise induced knee osteoarthritis, and to research the function, biomechanics of knee joint, and inflammatory factor in articular cavity. Method:Selecting 120 patients with exercise induced knee osteoarthritis, then they were randomly divided into control group (n=60) and intervene group (n=60). The patients in the control group were given conventional rehabmtation treating, and the intervene group were given intra-articular injection of sodium hyaluronate on this basic, they were treated 4 weeks. Evaluating the function of knee joint;conduct isokinetic muscle strength test (determination of the angIllar velocity were 60°/S, 180°/S);test the ratio of muscle peak torque and four muscles centripetal centripetal peak torque and peak torque, work load of femoral knee joints after (simultaneous determination of the angular velocity were 60°/S);detect the inflammatory factor in the joint fluid. Results: After the treatment, clinical effect in intervene group was superior to that in control group,but had no statistical significance;after the treatment, the score of function of knee joint in the two groups were higher than before treatment, and had statistical significance, and the score of function of knee joint in the intervene group were higher than control group, and the difference had statistical significance;Angular velocity of 60°/S and 180°/S the two groups peak torque, work load and the H/Q values were significantly increased, the intervene group were higher than control group, and the difference had statistical significance;inflammatory factor in the two groups were significantly decreased, the intervene group were lower than control group, and the difference had statistical significance.Conclusions: On the basic of rehabmtation treating, the treatment of intra-articular injection of sodium hyaluronate can improve the function of knee joint through improving the knee muscle strength, the level of their participation in the activities of the biomechanics of knee joint, and the inflammatory factor in the joint fluid.

关节镜下自体骨软骨移植对膝关节局限性软骨损伤的临床疗效评价

目的探讨关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的临床疗效,并以磁共振成像(MRI)检查对疗效进行评价。方法选取2018年6月至2021年6月诊治的100例膝关节局限性软骨损伤患者,按随机数字表法分为研究组和对照组,每组各50例。研究组采取关节镜下自体骨软骨移植术,对照组采取微骨折术治疗。采用MRI评估其手术疗效,并记录其术后膝关节软骨愈合时间;采用Lysholm膝关节功能评分表、国际膝关节文献委员会(IKDC)膝关节评估表,评估患者治疗前后膝关节功能变化;统计患者术后并发症发生率。结果研究组关节软骨愈合优良率98.00%,高于对照组84.00%(P<0.05)。两组术前和术后3个月的Lysholm评分、IKDC评分比较差异无统计学意义(P>0.05);术后6、12、24个月,研究组Lysholm评分、IKDC评分均高于对照组(P<0.05)。两组患者术后均无严重并发症,且并发症发生率差异无统计学意义(P>0.05)。研究组术后膝关节软骨愈合时间短于对照组(P<0.05)。结论关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的远期治疗效果显著,可有效改善患者术后膝关节功能,缩短膝关节软骨愈合时间,安全性高。

针刀疗法治疗膝骨关节炎的疗效及对患者膝关节功能的影响

目的探讨针刀疗法治疗膝骨关节炎的疗效及对患者膝关节功能的影响。方法随机将60例膝骨关节炎患者分为对照组与治疗组,各30例。治疗组采用针刀疗法治疗,对照组采用玻璃酸钠关节腔注射治疗。2组均治疗21 d,随访1年。对比2组治疗21 d后的临床疗效,治疗前、治疗21 d后的膝关节功能、生活质量及焦虑情绪,治疗期间的安全性,随访1年复发情况。结果治疗21 d后,治疗组总有效率(96.67%,29/30)高于对照组(73.33%,22/30)(P<0.05)。治疗21 d后,2组西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟评分(VAS)、膝关节炎严重性指数(ISOA)、关节炎贝克焦虑量表(BAI)评分降低,且治疗组更低(P<0.05)。治疗21 d后,2组关节活动度(ROM)、生活质量测量量表2(AIMS2-SF)、改良Barthel指数评定量表(MBI)评分升高,且治疗组更高(P<0.05)。治疗期间,2组不良反应发生率比较,差异无统计学意义(P>0.05);随访1年治疗组复发率更低(P<0.05)。结论针刀疗法治疗膝骨关节炎临床疗效较好,可改善患者膝关节功能,降低焦虑情绪,减少复发,提高生活质量,且安全性良好。

浮针治疗早中期膝骨关节炎对软骨厚度的影响

目的观察浮针疗法治疗早中期膝骨关节炎对关节软骨厚度的影响。方法将60例早中期膝骨关节炎患者随机分为治疗组和对照组,每组30例。治疗组采用浮针治疗,对照组采用电针治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、疼痛开始缓解时间、Lysholm膝关节功能评分、平衡功能及股骨内侧和外侧髁软骨厚度的变化。结果治疗组疼痛开始缓解时间短于对照组(P<0.05)。治疗后,两组VAS评分以及平衡功能的横向标准差和前后标准差均较治疗前降低(P<0.05),Lysholm膝关节功能评分、平衡功能的稳定极限均较治疗前升高(P<0.05)。治疗后3个月,两组VAS评分较治疗前降低(P<0.05),Lysholm膝关节功能评分较治疗前升高(P<0.05),膝关节内外侧髁软骨厚度均较治疗前增加(P<0.05)。治疗后和治疗后3个月,治疗组VAS评分均低于对照组(P<0.05),Lysholm膝关节功能评分均高于对照组(P<0.05)。治疗后,治疗组横向标准差低于对照组(P<0.05),稳定极限高于对照组(P<0.05)。结论浮针治疗早中期膝骨关节炎起效速度优于电针治疗,能有效缓解疼痛症状及提高膝关节功能,可改善软骨损伤。

针刺“相对穴”联合股四头肌等长收缩训练治疗老年膝骨关节炎的效果

目的探讨针刺“相对穴”联合股四头肌等长收缩训练用于老年膝骨关节炎(KOA)患者的价值。方法回顾性分析2021年5月至2023年5月承德医学院附属医院收治的106例老年KOA患者的临床资料,根据患者康复治疗方案不同将患者分为观察组(n=51)和对照组(n=55)。观察组给予患者针刺“相对穴”联合股四头肌等长收缩训练,对照组给予患者股四头肌等长收缩训练。比较两组患者康复效果及干预前后视觉模拟评分量表(VAS)、日常生活能力量表(ADL)、Lysholm评分及白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)、股四头肌峰力距值、股四头肌总功量值及股四头肌平均功率的差异。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。结果观察组患者康复效果总有效率显著高于对照组(90.20%和70.91%),差异有统计学意义(P<0.05)。观察组干预后VAS与ADL评分[(2.04±0.67)分、(2.08±0.80)分]显著低于干预前[(6.18±1.51)分、(7.56±1.49)分]及对照组干预后[(3.88±1.05)分、(3.97±1.22)分];Lysholm评分[(75.19±10.15)分]显著高于干预前[(55.95±6.53)分]及对照组干预后[(69.44±8.36)分],差异均有统计学意义(P<0.05)。观察组干预后关节滑液中IL-1β、TNF-α及VEGF水平[(6.19±1.00)pg/ml、(1.14±0.46)pg/ml、(320.36±37.12)ng/ml]显著低于干预前[(15.81±3.19)pg/ml、(5.50±1.03)pg/ml、(557.15±84.06)ng/ml]及对照组干预后[(9.16±2.12)pg/ml、(2.88±0.73)pg/ml、(411.50±50.27)ng/ml],差异均有统计学意义(P<0.05)。观察组患者干预后股四头肌峰力距值、股四头肌总功量值及股四头肌平均功率[(70.22±14.11)N.m、(418.94±73.15)J、(42.57±11.19)W]显著高于干预前[(52.14±10.36)N.m、(249.28±67.30)J、(30.69±8.25)W]及对照组干预后[(63.28±13.06)N.m、(355.24±70.27)J、(38.14±10.26)W],差异均有统计学意义(P<0.05)。康复治疗过程中仅观察组出现不良反应,其中皮下血肿1例,滞针2例,经对症处理后症状消失,未见膝关节疼痛、肿胀加剧情况。结论针刺“相对穴”联合股四头肌等长收缩训练可缓解老年膝骨关节炎患者的疼痛,提高患者关节功能。

138例全膝关节置换患者术前护患信任度现状及影响因素分析

目的旨在调查全膝关节置换患者术前护患信任度现状,并对其影响因素进行分析。方法采用便利抽样法,选取2020年10月—2021年9月期间在我科在行全膝关节置换术的138例患者为研究对象,采用一般资料调查量表、焦虑自评量表、膝关节美国特种外科评分表、护患关系信任度量表对患者进行调查,并进行多元线性回归分析,探讨全膝关节置换患者术前护信任度现状及其影响因素。结果本组患者术前护患信任度总分为(136.75±7.93)分;Pearson相关性分析结果显示,本组全膝关节置换患者术前1 d护患信任度总分与其焦虑评分总分呈负相关(r=-0.419,P<0.01),与膝关节功能评分无相关性(r=0.063,P>0.05)。多元线性回归分析结果显示,既往有无住院经历、文化程度及术前焦虑评分进入回归方程(P<0.05),共解释总变异的66.9%。结论本组全膝关节置换患者术前护患信任度处于中等偏上水平,且受文化程度、既往有无住院经历、术前焦虑程度的影响,护理人员应重点关注文化水平低、无既往住院经历、焦虑程度高的患者,针对性的对以上患者进行干预,以减少患者术后焦虑及改善术后功能,促进医患关系,减少医疗纠纷,帮助患者尽早康复。

补肾活血疗法结合针刺治疗膝骨关节炎疗效及对膝关节功能、生活质量的影响

目的观察补肾活血疗法结合针刺治疗膝骨关节炎的临床疗效及对患者膝关节功能、生活质量的影响。方法研究纳入2021年1月—2023年3月四川省骨科医院诊治的肾虚血瘀型膝骨关节炎患者128例,以随机数字表法分为中西医结合组与对照组各64例,对照组给予美洛昔康片、盐酸氨基葡萄糖胶囊及玻璃酸钠注射液治疗,中西医结合组在对照组治疗基础上给予补肾活血疗法及针刺治疗。2组治疗时间均为1个月,治疗过程中每组各脱落2例。比较2组患者治疗前后中医证候积分、西安大略和麦克马斯特大学骨关节炎指数可视化量表(WOMAC)评分、疼痛视觉模拟评分法(VAS)评分、生活质量健康状况调查简表(SF-36)评分、关节活动度、步速、步长,统计2组临床疗效及不良反应发生情况。结果2组患者治疗后中医证候积分、WOMAC评分、VAS评分均明显降低(P均<0.05),SF-36评分、关节活动度、步速、步长均明显增加(P均<0.05),且中西医结合组上述各指标改善情况均明显优于对照组(P均<0.05);中西医结合组治疗总有效率明显高于对照组[96.77%(60/62)比87.10%(54/62),P<0.05];2组患者不良反应发生率均较低(对照组2例,中西医结合组3例),组间比较差异无统计学意义(P>0.05)。结论补肾活血疗法结合针刺治疗膝骨关节炎临床疗效显著,可明显减轻疼痛和相关症状,改善膝关节功能,提高生活质量,且应用安全。

关节镜下双Endobutton钛板固定治疗单侧Rockwood Ⅲ型急性肩锁关节脱位的临床疗效观察

目的探讨关节镜辅助下双Endobutton钛板固定治疗患者单侧RockwoodⅢ型急性肩锁关节脱位的临床疗效。方法采用回顾性研究方法,选取2022年1月至2023年7月在首都医科大学附属北京友谊医院收治的单侧RackwoodⅢ型急性肩锁关节脱位的患者49例,根据手术方式的不同分为观察组(n=27)和对照组(n=22)。观察组接受关节镜辅助下肩锁关节脱位复位、双Endobutton钛板内固定手术治疗,对照组接受传统的切开复位锁骨钩钢板内固定手术治疗。所有患者进行门诊随访,记录术前、术后12周和末次随访时患者的视觉模拟疼痛评分(VAS)、美国加州大学洛杉矶分校肩关节系统评分(UCLA)以及肩关节正位X线上肩锁关节间距(ACD)和喙锁关节间距(CCD),并比较两种治疗方法的临床疗效。结果所有患者得到完整随访,随访时间为25.3~30.6周,平均(28.8±2.1)周。所有患者均未出现血管和神经损伤并发症。术后12周和末次随访,两组患者的VAS评分较术前有明显降低,UCLA肩关节评分均较术前升高,差异均有统计学意义(P<0.05);观察组和对照组术后12周和末次随访的VAS[(3.1±0.5)分vs.(3.3±0.6)分,(2.8±0.6)分vs.(2.7±0.8)分]、UCLA肩关节评分[(33.5±3.6)分vs.(33.7±3.2)分,(34.1±2.9)分vs.(34.7±2.6)分]比较,差异均无统计学意义(P>0.05)。术后12周和末次随访,两组患者的ACD和CCD均小于术前,差异均有统计学意义(P<0.05);两组间术后12周和末次随访的ACD[(5.2±1.8)分vs.(5.6±2.1)分,(5.1±1.7)分vs.(5.5±2.0)分]和CCD[(7.4±2.9)分vs.(7.2±2.5)分,(7.5±2.6)分vs.(7.1±2.6)分]比较,差异均无统计学意义(P>0.05)。末次随访观察组和对照组的优良率比较(81.6%vs.81.8%),差异无统计学意义(P>0.05)。结论关节镜下复位单侧RockwoodⅢ型急性肩锁关节脱位并使用双Endobutton钛板固定能够获得良好的治疗效果,与传统的切开复位钩钢板固定没有临床疗效的差异。

腹-膝结合针灸治疗老年性膝骨性关节炎的效果观察

目的观察腹-膝结合针灸治疗老年性膝骨性关节炎的疗效。方法63例老年性膝骨性关节炎患者,随机分为腹-膝结合治疗组(32例)和常规针刺组(31例)。腹-膝结合组采用腹-膝结合针灸治疗,常规针刺组采用常规穴位针灸治疗。比较两组患者治疗前后修订版面部表情疼痛量表(FPS-R)评分、西安大略和曼彻斯特大学骨性关节炎指数(WOMAC)评分。结果腹-膝结合组与常规针刺组FPS-R评分在治疗前相比无差异(P>0.05);治疗后腹-膝结合组与常规针刺组FPS-R评分均低于治疗前,且腹-膝结合组FPS-R评分(2.33±1.02)分低于常规针刺组的(2.98±0.81)分(P<0.05)。腹-膝结合组与常规针刺组WOMAC评分在治疗前相比无差异(P>0.05);治疗后腹-膝结合组与常规针刺组WOMAC评分均低于治疗前,且腹-膝结合组WOMAC评分(29.01±12.09)分低于常规针刺组的(36.71±13.61)分(P<0.05)。结论腹-膝结合针灸治疗老年性膝骨性关节炎在缓解患者疼痛、改善膝关节功能方面均优于常规针刺。

关节镜联合C型臂X线机治疗胫骨平台骨折的疗效

目的探讨关节镜联合C型臂X线机治疗胫骨平台骨折的效果。方法方便选择2017年1月—2022年12月丹阳市人民医院收治的78例胫骨平台骨折患者为研究对象,以随机双盲法分为两组,每组39例。对照组行常规切开复位内固定术,观察组行关节镜联合C型臂X线机微创内固定术,对两组手术疗效、手术指标、膝关节功能恢复与并发症发生情况进行分析比较。结果观察组手术优良率(97.44%)明显高于对照组(82.05%),差异有统计学意义(χ^(2)=5.014,P<0.05);观察组手术治疗相关指标优于对照组,差异有统计学意义(P均<0.05)。术后6个月两组患者Lysholm、纽约特种外科医院(Hospital for Special Surgery,HSS)评分均升高,且观察组Lysholm、HSS评分明显高于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P均<0.05)。结论胫骨平台骨折患者采用关节镜联合C型臂X线机治疗的疗效确切,患者创伤小、术后恢复快、并发症少,且对患者膝关节功能的恢复有着明显的促进作用。