可注射性生物复合材料修复老年膝关节软骨损伤的应用分析

摘要

Objective To investigate the effect of injectable bio composite materials in the repair of articular cartilage injury of knee joint in elderly patients.Methods Twenty fourcases of elderly patients with articular cartilage injury in knee joint from January 2015 to February 2016 in our hospital were equally divided into 2 groups according to the envelope method.All the patients were given arthroscopic surgery, and patients in control group (n=12) and observation group (n=12) were injected with bone cement andnanocrystalline calcium phosphate/collagen materials for bone repair respectively.The pain and knee joint function were observed before and after operation.Results The excellent and good rate in observation group was higher than that of control group (91.7% vs.66.7%, P<0.05) at 3 months after operation.At 3 months after operation, the pain scoresof observation group and control group were decreased from (4.94±2.61) and (4.84±2.53) to (2.11±1.54) and (3.61±1.44) respectively;meanwhile, there was significant difference between the two groups (P<0.05).The Lysholm knee function scores in the two groupsincreased at 3 months after operation (P<0.05), and the score in observation group was higher than that of control group (P<0.05).The incidence rate of pulmonary infection, thrombus embolism, lower limb swelling and incision infection in observation group was lower than that of control group (16.7% vs.58.3%,P<0.05).Conclusion Injectable bio composite materials-nanocrystalline calcium phosphate/collagen materials has good efficacy in the repair of articular cartilage injury of knee joint in elderly patients, it also can reduce the complications, and the mechanism may be related to the effective alleviation and improvement of kneefunction.%目的 探讨可注射性生物复合材料修复老年膝关节软骨损伤的应用.方法 采用前瞻性研究方法,选择2015年1月至2016年2月在我院诊治的老年膝关节软骨损伤24例,根据信封随机抽取法分为观察组与对照组,每组12例,两组都给予关节镜下手术治疗,对照组注射骨水泥进行修复,观察组使用纳米晶磷酸钙/胶原基骨材料进行修复,观察手术前后疼痛与膝关节功能情况.结果 术后3个月,观察组和对照组的疗效优良率分别为91.7%与66.7%,观察组明显高于对照组(P<0.05);观察组和对照组疼痛评分分别为(2.11±1.54)、(3.61±1.44)分,明显低于术前的(4.94±2.61)、(4.84±2.53)分(P<0.05),且观察组的术后评分明显低于对照组(P<0.05);观察组与对照组术后Lysholm膝关节功能评分均明显高于术前(P<0.05),且观察组的术后评分明显高于对照组(P<0.05).观察组与对照组术后3个月的血栓栓塞、肺部感染、下肢肿胀等并发症发生率分别为16.7%、58.3%,观察组明显低于对照组(P<0.05).结论 可注射性生物复合材料-纳米晶磷酸钙/胶原基骨材料修复老年膝关节软骨损伤具有很好的疗效,能减少并发症的发生,其作用机制可能与有效缓解及改善膝关节功能有关.