关节镜清理术后定期注射玻璃酸钠与关节 置换治疗膝骨性关节炎的短期对比研究

Comparison of clinical short-term effect of arthroscopic debridement combined with regular injection of sodium hyaluronate and arthroplasty for knees osteoarthritis

摘要:

目的 回顾性研究关节镜清理术后定期注射玻璃酸钠可否在一定期限内替换关节置换治疗膝骨性关节炎。 方法 2008年1月~2012年8月在该院接受治疗的膝骨性关节炎的患者共622例，病程6个月~15年，其中行全膝置换的患者272例，关节镜清理术后分别于术后1周，半年，以后每1年注射一次玻璃酸钠的患者共350例。 结果 所有患者均经过临床随访6～65个月，平均36.5个月，两种治疗方法不同时期治疗结果优良率比较置换组略差于关节镜组；按HSS评分标准膝关节评分，两组病例治疗前后差异均有显著性，但两组间比较除了6个月时差异有显著性（置换组好于关节镜组）外，其他月份差异均无显著性。 结论 关节镜清理术后定期注射玻璃酸钠是一种可在短期内替换关节置换治疗膝骨性关节炎的有效方法，最大程度提高了患者的生活质量，但其替换时限仍有待进一步观察。

Abstract:

【Objective】 To evaluate retrospectively arthroscopic debridement combined with regular injection of sodium hyaluronate whether or not can replace arthroplasty within a certain period of treatment of knee osteoarthritis. 【Methods】 From January 2008 to August 2012. 622 patients treated for osteoarthritis were reviewed postoperatively using a questionnaire and physical examination, duration of 6 months to 15 years. 350 knees with osteoarthritis were treated by arthroscopic debridement and intra-articular injection of sodium hyaluronate after the operation. 272 knees with osteoarthritis were treated by arthroplastic. 【Results】 The patients were followed up from 6 to 65 months with an average of 36.5 months. The excellent and good rate of the knee joint function was arthroscopic slightly better than arthroplastic group. According to HSS knee rating score standards, two groups had significant difference before and after treatment, but in addition to the 6 months difference compared between two groups was statistically significant (substitution groups were better than arthroscopic group), the other month had no statistical significance. 【Conclusion】 Arthroscopic debridement combined with regular injection of sodium hyaluronate replace arthroplasty in the short term is an effective treatment for knee osteoarthritis, could improve the patient's quality of life to the greatest degree, but the replacement time remains to be further observed.