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膝关节骨关节炎关节镜治疗后的临床结果

Clinical outcomes after arthroscopic treatment of knee osteoarthritis.

作者信息

Figueroa David, Calvo Rafael, Villalón Ignacio E, Meleán Patricio, Novoa Felipe, Vaisman Alex

机构信息

Orthopaedic Surgery Department, Clínica Alemana de Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile.

出版信息

Knee. 2013 Dec;20(6):591-4. doi: 10.1016/j.knee.2012.09.014. Epub 2012 Oct 25.

Abstract

PURPOSE

The aim of this study was to describe the clinical outcomes of patients with knee osteoarthritis (OA) treated with arthroscopic surgery, documenting the associated injuries and defining the type of treatment selected for OA patients with different symptoms.

HYPOTHESIS

Knee arthroscopy is effective for treating patients with symptomatic OA and mechanical symptoms.

METHODS

This was a prospective, consecutive series of 100 patients with a clinical and radiological diagnosis of OA who were treated with knee arthroscopy. The average follow-up time was 35.9months (25-71), and the average age was 60.1years (50-83).

INCLUSION CRITERIA

50years of age, a clinical imaging diagnosis of knee OA with an Ahlbäck I-III classification.

EXCLUSION CRITERIA

<50years of age, Ahlbäck IV, pathologic lower limb mechanical axis and inflammatory joint diseases. The IKDC and Lysholm scores were assessed before and after surgery.

RESULTS

The preoperative average scores were as follows: Lysholm, 56.9±13.5 points (22-71); IKDC, 59.4±21.7 points (45-80). The postoperative average scores were as follows: Lysholm, 86.9 points (22-87); IKDC, 79.5 points (45-100). Regarding the Lysholm scores, 76% were good and excellent results and 24% were moderate (p=0.045). The associated injuries included 48% of chondral and 36% of unstable meniscal injuries. Good or excellent results were observed in 76% of the meniscal injury cases according to the Lysholm scores, while only 84.6% of the cases with unstable chondral lesions had good or excellent results (p=0.035).

CONCLUSION

Most patients with knee OA associated with unstable cartilage or meniscal injuries reported good-to-excellent symptomatic results at the short- and mid-term follow-ups.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究旨在描述接受关节镜手术治疗的膝关节骨关节炎(OA)患者的临床结局,记录相关损伤情况,并确定针对不同症状的OA患者所选择的治疗类型。

假设

膝关节镜检查对治疗有症状的OA和机械性症状患者有效。

方法

这是一项前瞻性、连续性研究,纳入了100例经临床和影像学诊断为OA且接受膝关节镜检查的患者。平均随访时间为35.9个月(25 - 71个月),平均年龄为60.1岁(50 - 83岁)。

纳入标准

年龄>50岁,临床影像学诊断为膝关节OA,Ahlbäck分级为I - III级。

排除标准

年龄<50岁,Ahlbäck IV级,病理性下肢机械轴以及炎性关节疾病。术前和术后评估IKDC和Lysholm评分。

结果

术前平均评分如下:Lysholm评分为56.9±13.5分(22 - 71分);IKDC评分为59.4±21.7分(45 - 80分)。术后平均评分如下:Lysholm评分为86.9分(22 - 87分);IKDC评分为79.5分(45 - 100分)。关于Lysholm评分,76%为良好和优秀结果,而24%为中等结果(p = 0.045)。相关损伤包括48%的软骨损伤和36%的不稳定半月板损伤。根据Lysholm评分,76%的半月板损伤病例获得良好或优秀结果,而不稳定软骨损伤病例中只有84.6%获得良好或优秀结果(p = 0.035)。

结论

大多数伴有不稳定软骨或半月板损伤的膝关节OA患者在短期和中期随访中报告了良好至优秀的症状改善结果。

证据级别

III级。

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