关节镜治疗膝关节骨软骨骨折的临床疗效

摘要

目的 观察关节镜下治疗膝关节骨软骨骨折的临床疗效.方法 回顾性分析成都市温江区人民医院2008年6月至2010年3月收治的42例膝关节骨软骨骨折患者的临床资料,其中经关节镜治疗22例(关节镜组),常规手术治疗20例(常规手术组).2组患者术后随访24个月.术前及术后均采用Lysholm膝关节功能评分法评价膝关节功能,比较2种手术方法的临床疗效.结果 关节镜组患者术后总有效率为90.9％,其中疗效优16例,良4例,差2例；平均Lysholm评分由术前的33.1 ±15.9提高至92.3±15.1,手术前后比较差异有统计学意义(P＜0.05)；常规手术组患者总有效率为70.0％,其中疗效优12例,良2例,差6例；平均Lysholm评分由术前的32.7±12.6提高至81.2±8.8,手术前后比较差异有统计学意义(P＜0.05).2组患者的临床疗效比较差异有统计学意义(P＜0.05)；2组术后Lysholm膝关节功能评分比较差异亦有统计学意义(P＜0.05).结论 关节镜下治疗膝关节骨软骨骨折较常规手术治疗疗效好,且关节镜手术操作简便,创伤小,患者术后恢复快.%Objective To observe the clinical effect of knee cartilage fracture treated by arthroscopes. Methods Data of 42 cases who had operation of knee cartilage fracture from June 2008 to March 2010 were analyzed retrospectively. Twenty-two cases in arthroscopes group received treatment of arthroscopic microfracture technique, the other 20 cases in operation group received treatment of open operation. Patients in the two groups were followed up for 24 months. Lysholm score was used for evaluation before and after the operation in both groups and their clinical effects were compared. Results Both procedures resulted in a significant improvement compared to the situation before the operation. In the arthroscopes group whose total effective rate was 90.9%, 16 cases showed excellent result, 4 cases were good result and 2 cases had bad result, and the mean of Lysholm score improved significantly from 33.1 ±15.9 to 92.3 ±15. l(P<0. 05). In the open operation group whose total effective rate was 70. 0%, 12 cases showed excellent result, 2 cases were good result and 6 cases had bad result, and the mean of Lysholm score improved significantly from 32.7 ± 12.6 to 81.2 ±8.8(P<0.05). There were significant differences of total effective rate and Lysholm score after treatment between the arthroscopes group and the open operation group(P <0. 05). Conclusion The clinical effect of knee cartilage fracture treated by arthroscopes is better than that treated by open operation. Arthroscopes operation has the advantage of convenient operation, small injury and quick postoperative recovery.