关节镜下微创清理术在非症状性膝关节骨性关节炎患者中的应用效果

Effect of arthroscopic debridement on patients with non symptomatic knee osteoarthritis

摘要:

目的  研究关节镜下微创清理术对非症状性膝关节骨性关节炎（OA）患者关节功能及生活质量的影响。方法  将2012年1月-2014年1月该院收治的膝关节OA患者70例纳入研究对象，采用随机数字表法分为观察组和对照组，对照组给予美洛昔康口服治疗，观察组进行关节镜下微创清理术，比较两组患者的关节功能、生活质量以及关节液中基质金属蛋白酶（MMPs）含量。结果  ①关节功能：观察组患者的WOMAC骨关节炎指数低于对照组[（41.45±6.83） vs （57.52±7.05）]，Lysholm评分和Tenger评分高于对照组[（72.32±10.41） vs （58.42±8.92），（5.49±0.68） vs （4.21±0.62）]；②生活质量：观察组患者的躯体健康、心理健康、社会功能和物质条件高于对照组[（59.82±9.61） vs （45.27±8.33），（66.03±7.52） vs （52.17±5.93），（67.65±8.34） vs （54.01±6.72），（58.23±7.16） vs （51.29±5.32）]；③关节液中MMPs含量：观察组患者关节液中MMP1和MMP3含量低于对照组[（1.05±0.12） vs （1.73±0.22），（14.73±1.78） vs （25.72±3.18）]。结论  关节镜下微创清理术能够有助于改善非症状性膝关节OA患者的关节功能、提高生活质量，降低关节液中MMP1和MMP3含量。

Abstract:

【Objective】 To study the effect of arthroscopic debridement on knee joint function and life quality of osteoarthritis patients. 【Methods】 70 cases of osteoarthritis patients in our hospital from 2013 January to 2014 January were randomly divided into observation group and control group. Observation group received arthroscopic debridement, control group received meloxicam oral therapy. Then joint function, quality of life as well as MMPs content in synovial fluid were compared. 【Results】 Joint function: observation group WOMAC osteoarthritis index were lower than those of control group [(41.45 ± 6.83) vs (57.52 ± 7.05)]; Lysholm score and Tenger score were higher than those of control group [(72.32 ± 10.41) vs (58.42 ± 8.92), (5.49 ± 0.68) vs (4.21 ± 0.62)]; quality of life: observation group physical health, mental health, social function, material conditions score were higher than those of control group [(59.82 ± 9.61) vs (45.27 ± 8.33), (66.03 ± 7.52) vs (52.17 ± 5.93), (67.65 ± 8.34) vs (54.01 ± 6.72), (58.23 ± 7.16) vs (51.29 ± 5.32)]; MMPs content in synovial fluid: observation group MMP1, MMP3 content in synovial fluid were lower than those of control group [(1.05 ± 0.12) vs (1.73 ± 0.22), (14.73 ± 1.78) vs (25.72 ± 3.18)]. 【Conclusion】 Arthroscopic debridement can help improve the joint function and improve the quality of life and reduce the content of MMP1 and MMP3 in synovial fluid of patients with non symptomatic knee osteoarthritis.