Spahn G, Klinger H M, Hofmann G O
Praxisklinik für Unfallchirurgie und Orthopdädie Eisenach.
Universitätsklinikum Göttingen.
Sportverletz Sportschaden. 2013 Dec;27(4):226-31. doi: 10.1055/s-0033-1355854. Epub 2013 Nov 6.
This study is aimed to compare the effects of arthroscopic joint debridement over a 5-year period in a clearly defined patient population (only grade III knee osteoarthritis, history < 2 years).
A total of 96 patients (50 male and 46 female) underwent arthroscopic knee debridement for knee OA. The main criteria for inclusion were osteoarthritis grade III (Kellgren-Lawrence score) and a maximal history of 2 years.
The subjective complaints and the knee-related quality of life were estimated by the KOOS (knee injury and osteoarthritis outcome score). The score increased significantly within the 1 to 3 rd year post operation. After this interval the mean points of the score declined. But after 5 years the KOOS was higher in comparison to the baseline dates. Patients who had undergone conservative treatment at baseline had a significantly different KOOS than patients in the arthroscopy group. Over time, patients in the arthroscopy group had fewer complaints than patients in the conservative treatment group. In both groups, the results decreased over time. A total of 17 patients (17.2 %) needed a conversion to total endoprothetic replacement. The mean time-interval between index operation and conversion was 56.6 (95 % CI 54.4 - 58.4) months.
In middle stages of knee OA, arthroscopic joint debridement can effectively reduce subjective complaints. Because this treatment does not stop the process of OA, the improvements decrease over time.
本研究旨在比较在明确界定的患者群体(仅III级膝骨关节炎,病程<2年)中,关节镜下关节清理术在5年期间的效果。
共有96例患者(50例男性和46例女性)因膝骨关节炎接受了关节镜下膝关节清理术。纳入的主要标准为III级骨关节炎(Kellgren-Lawrence评分)且最长病程为2年。
通过膝关节损伤和骨关节炎疗效评分(KOOS)评估主观症状和与膝关节相关的生活质量。术后1至3年评分显著提高。在此间隔之后,评分的平均分下降。但5年后,KOOS评分相较于基线数据更高。基线时接受保守治疗的患者与关节镜组患者的KOOS评分有显著差异。随着时间推移,关节镜组患者的症状比保守治疗组患者更少。在两组中,结果均随时间下降。共有17例患者(17.2%)需要转为全关节置换。初次手术与转换手术之间的平均时间间隔为56.6(95%CI 54.4 - 58.4)个月。
在膝骨关节炎的中期,关节镜下关节清理术可有效减轻主观症状。由于这种治疗并不能阻止骨关节炎的进程,随着时间推移改善效果会下降。