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[1]劉輝,陳先進,錢輝.關節(jié)鏡下內(nèi)側半月板成形術聯(lián)合小針刀內(nèi)側副韌帶深層拉花樣松解術治療膝骨關節(jié)炎合并內(nèi)側半月板損傷的臨床研究[J].中醫(yī)正骨,2021,33(11):18-23.
　LIU Hui,CHEN Xianjin,QIAN Hui.A clinical study of arthroscopic medial meniscoplasty combined with deep medial collateral ligament pie-crusting release with small needle-knife for treatment of knee osteoarthritis and medial meniscus tears[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(11):18-23.
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關節(jié)鏡下內(nèi)側半月板成形術聯(lián)合小針刀內(nèi)側副韌帶深層拉花樣松解術治療膝骨關節(jié)炎合并內(nèi)側半月板損傷的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年11期
頁碼:
18-23
欄目:
臨床研究
出版日期:
2021-11-20

文章信息/Info

Title:
A clinical study of arthroscopic medial meniscoplasty combined with deep medial collateral ligament pie-crusting release with small needle-knife for treatment of knee osteoarthritis and medial meniscus tears
作者:
劉輝; 陳先進; 錢輝
(蕪湖市中醫(yī)醫(yī)院,安徽 蕪湖 241000)
Author(s):
LIU Hui; CHEN Xianjin; QIAN Hui
Wuhu Hospital of Traditional Chinese Medicine,Wuhu 241000,Anhui,China
關鍵詞:
骨關節(jié)炎; 膝;  半月板; 脛骨;  關節(jié)鏡檢查;  內(nèi)側副韌帶; 膝;  小刀針;  臨床試驗
Keywords:
osteoarthritis; knee;  menisci; tibial;  arthroscopy;  medial collateral ligament; knee;  small knife needle;  clinical trial
摘要:
目的:比較關節(jié)鏡下內(nèi)側半月板成形術聯(lián)合小針刀內(nèi)側副韌帶深層拉花樣松解術與單純關節(jié)鏡下內(nèi)側半月板成形術治療膝骨關節(jié)炎合并內(nèi)側半月板損傷的臨床療效。方法:將符合要求的50例膝骨關節(jié)炎合并內(nèi)側半月板損傷患者隨機分為2組,每組25例,分別采用關節(jié)鏡下內(nèi)側半月板成形術聯(lián)合小針刀內(nèi)側副韌帶深層拉花樣松解術(聯(lián)合手術組)和單純關節(jié)鏡下內(nèi)側半月板成形術(內(nèi)側半月板成形組)治療。分別于術前及術后3個月、6個月記錄并比較2組患者的脛股角(femoral-tibial-angle,FTA)、膝部疼痛視覺模擬量表(visual analogue scale,VAS)評分和Lysholm膝關節(jié)評分。結果:①脛股角。時間因素和分組因素存在交互效應(F=13.329,P=0.021); 2組患者脛股角總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=16.331,P=0.004); 治療前后不同時間點之間2組患者脛股角的差異有統(tǒng)計學意義,即存在時間效應(F=16.359,P=0.031); 聯(lián)合手術組患者脛股角隨時間呈先下降后上升趨勢,但內(nèi)側半月板成形組患者脛股角不隨時間發(fā)生明顯變化(178.35°±1.69°,174.12°±1.24°,176.24°±1.78°,F=18.531,P=0.000; 178.26°±1.91°,178.38°±2.43°,181.34°±1.51°,F=4.755,P=0.091)。術前2組患者脛股角比較,差異無統(tǒng)計學意義(t=21.397,P=1.787); 術后3個月、6個月,聯(lián)合手術組脛股角均小于內(nèi)側半月板成形組(t=8.351,P=0.010; t=9.891,P=0.023)。②膝部疼痛VAS評分。時間因素和分組因素存在交互效應(F=10.275,P=0.021); 2組患者膝部疼痛VAS評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=11.336,P=0.000); 治療前后不同時間點之間2組患者膝部疼痛VAS評分的差異有統(tǒng)計學意義,即存在時間效應(F=221.190,P=0.000); 2組患者膝部疼痛VAS評分均隨時間呈先下降后上升趨勢,但2組的變化趨勢不完全一致[(6.75±2.14)分,(2.05±0.96)分,(2.66±1.24)分,F=251.378,P=0.000;(6.83±1.92)分,(2.07±1.29)分,(3.73±1.27)分,F=196.977,P=0.000]。術前2組患者膝部疼痛VAS評分比較,差異無統(tǒng)計學意義(t=0.952,P=0.801); 術后3個月、6個月,聯(lián)合手術組膝部疼痛VAS評分均低于內(nèi)側半月板成形組(t=7.399,P=0.011; t=9.257,P=0.000)。③Lysholm膝關節(jié)評分。時間因素和分組因素存在交互效應(F=9.399,P=0.016); 2組患者Lysholm膝關節(jié)評分總體比較,差異有統(tǒng)計學意義,即存在分組效應(F=19.541,P=0.000); 治療前后不同時間點之間2組患者Lysholm膝關節(jié)評分的差異有統(tǒng)計學意義,即存在時間效應(F=187.320,P=0.000); 2組患者Lysholm膝關節(jié)評分均隨時間呈先上升后下降趨勢,但2組的變化趨勢不完全一致[(42.15±12.14)分,(71.50±19.22)分,(61.72±18.26)分,F=197.478,P=0.000;(42.13±10.92)分,(63.65±18.35)分,(55.43±17.08)分,F=164.597,P=0.000]。術前2組患者Lysholm膝關節(jié)評分比較,差異無統(tǒng)計學意義(t=1.397,P=0.423); 術后3個月、6個月,聯(lián)合手術組Lysholm膝關節(jié)評分均高于內(nèi)側半月板成形組(t=8.491,P=0.000; t=6.352,P=0.000)。結論:關節(jié)鏡下內(nèi)側半月板成形術聯(lián)合內(nèi)側副韌帶深層拉花樣松解術治療膝骨關節(jié)炎合并內(nèi)側半月板損傷,能在一定程度上糾正膝關節(jié)內(nèi)翻畸形,緩解膝部疼痛,改善膝關節(jié)功能,療效優(yōu)于單純的關節(jié)鏡下內(nèi)側半月板成形術。
Abstract:
Objective:To compare the clinical curative effects of combination therapy of arthroscopic medial meniscoplasty and deep medial collateral ligament(dMCL)pie-crusting release with small needle-knife versus monotherapy of arthroscopic medial meniscoplasty for treatment of knee osteoarthritis(KOA)and medial meniscus tears(MMTs).Methods:Fifty patients with KOA and MMTs were enrolled in the study and were randomly divided into 2 groups,25 cases in each group,and they were treated with arthroscopic medial meniscoplasty combined with dMCL pie-crusting release with small needle-knife(combination therapy group)and arthroscopic medial meniscoplasty alone(monotherapy group)respectively.The femoral-tibial-angle(FTA),knee pain visual analogue scale(VAS)score and Lysholm knee score(LKS)were recorded and compared between the 2 groups before the surgery and at 3 and 6 months after the surgery respectively.Results:①There was interaction between time factor and group factor in FTA(F=13.329,P=0.021).There was statistical difference in FTA between the 2 groups in general,in other words,there was group effect(F=16.331,P=0.004).There was statistical difference in FTA between different timepoints before and after the treatment,in other words,there was time effect(F=16.359,P=0.031).The FTA presented a time-dependent trend of decreasing firstly and increasing subsequently in combination therapy group,while it was not obviously changed with time in monotherapy group(178.35±1.69,174.12±1.24,176.24±1.78 degrees,F=18.531,P=0.000; 178.26±1.91,178.38±2.43,181.34±1.51 degrees,F=4.755,P=0.091)...

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備注/Memo

備注/Memo:
基金項目:安徽省中醫(yī)藥領軍人才建設項目(中醫(yī)藥發(fā)展秘〔2018〕23號)
通訊作者:陳先進 E-mail:[email protected]
更新日期/Last Update: 1900-01-01