关节镜辅助下关节清理术结合康复训练治疗膝关节骨性关节炎的临床研究
Effect of arthroscopic debridment combined with rehabilitation training in the treatment of knee osteoarthritis
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摘要: 目的：研究关节镜辅助下关节清理术结合康复训练对膝关节骨性关节炎（KOA）的临床疗效。方法：收集确诊为KOA的病人138例（均为单膝），随机分为2组，对照组进行单纯关节镜下清扫术治疗，观察组进行关节镜下清扫术结合康复训练，比较2组不同分期KOA病人治疗前后的膝关节功能评分（Lysholm评分）以及疼痛评分（VAS评分）。结果：所有病人治疗2个月后，不同Kellgren-Lawrence X线分级KOA病人VAS评分均较治疗前明显降低（P<0.01），Lysholm评分均明显升高（P<0.01）。治疗后2个月，2组对应的Kellgren-Lawrence X线分级Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级病人VAS评分显著低于治疗前（P<0.01），Lysholm评分显著高于治疗前（P<0.01）；观察组Ⅰ级和Ⅱ级病人VAS评分显著低于对照组（P<0.01），Lysholm评分则显著高于对照组（P<0.01）；2组Ⅲ级、Ⅳ级病人膝关节疼痛及功能评分差异均无统计学意义（P>0.05）。观察组行关节镜下清理术结合康复训练后总有效率高于对照组（P<0.05）。结论：关节镜辅助下关节清理术能明显改善KOA病人膝关节功能并减轻其疼痛，术后结合康复训练能进一步减轻Ⅰ级和Ⅱ级病人的痛感并改善膝关节功能。Abstract: Objective: To observe the clinical effects of arthroscopic debridement combined with rehabilitation training in the treatment of knee osteoarthritis(KOA).Methods: One hundred and thirty-eight patients with KOA were randomly divided into the control group and observation group.The control group were treated with arthroscopic debridement,and the observation group were treated with arthroscopic debridement combined with rehabilitation training.The VAS score of knee pain and Lysholm score of knee in two groups before and after treatment joint function were evaluated.Results: Compared before treatment,the scores of VAS and Lysholm in Kellgren-Lawrence X-ray level Ⅰ,Ⅱ,Ⅲ and Ⅳ patients in two groups significantly decreased and increased after 2 months of treatment,respectively(P<0.01).The scores of VAS and Lysholmin in levelⅠand Ⅱpatients in observation group were significantly lower and higher than that in control group,respectively(P<0.01).The differences of the scores of knee joint pain and function between level Ⅲ and Ⅳ patients in two groups were not statistically significant(P>0.05).The total effective rate in observation group was higher than that in control group(P<0.05).Conclusions: Arthroscopic debridement combined with rehabilitation training can significantly improve the knee joint function,and reduce the pain in patients with KOA.The postoperative rehabilitation training can further alleviate the pain,and improve the knee joint function in levelⅠand Ⅱ patients.
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Key words:
- osteoarthritis /
- knee /
- arthroscopy /
- arthroscopic debridement /
- rehabilitation training
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