轻中度髌股关节炎关节镜治疗的疗效观察

摘要

目的:观察关节镜下关节腔清理或低温等离子刀髌骨外侧支持带松解术联合髌骨周围部分去神经化治疗轻中度髌股关节炎的临床疗效.方法:选取我科2013年3月～2015年9月收住的轻中度髌股关节炎患者50例共54膝,关节镜下按Outerbridge分级法对髌股关节损伤软骨进行分级,并行关节腔清理或低温等离子刀外侧支持带松解术联合髌周部分去神经化治疗,术后指导患膝康复锻炼,比较术前和术后6个月Kujala髌股关节专项评分和视觉模拟疼痛(VAS)评分结果,评价治疗效果.结果:48例患者共52膝获得随访,随访时间6～12个月,平均(8.8±1.5)个月,术后6个月所有患者Kujala评分较术前均提高,VAS评分较术前均降低(P＜0.05),差异有统计学意义.结论:对于轻中度软骨损伤的髌股关节炎患者,关节镜下关节腔清理、低温等离子刀外侧支持带松解术联合髌骨周围部分去神经化治疗可取得良好的效果,明显改善膝关节功能,减轻疼痛.%Objective:To investigate the curative effect of the treatment of patellofemoral osteoarthritis (PFOA) with arthroscopic debridement or lateral retinacular release combined with circumpatellar denervation using low-temperature plasma radiofrequency.Methods:Fifty patients with PFOA(involvement of 54 knees) undergone treatment in our department were included from March 2013 through September 2015.The injury degree of cartilages at the patellofemoral joint was graded with Outerbridge scoring system.All patients underwent arthroscopic debridement or lateral retinacular release combined with circumpatellar denervation using low-temperature plasma radiofrequency,and were given instructions for postoperative rehabilitation exercise.The therapeutic effects were evaluated using Kujala scoring and VAS scores before and after surgery.Results:Forty-eighty patients received follow-up in 52 knees in between 6 and 12 months,with a average of(8.8 ± 1.5)months.Kujala scores were improved and lower VAS scores were observed in all patients 6 months after treatment.The scoring on the two indicators was different before and after surgery (P＜ 0.05).Conclusion:Arthroscopic debridement and lateral retinacular release combined with circumpatellar denervation using low-temperature plasma radiofrequency may lead to better curative effects,including improved knee-joint function and reduced knee pain,for patients with minor/moderate patellofemoral osteoarthritis.