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膝关节病患者关节镜手术的早期和晚期结果

Early and late-term results of arthroscopic surgery on patients with gonarthrosis.

作者信息

Yilar Sinan, Yildirim Omer Selim

机构信息

Department of Orthopaedics and Traumatology, Gumushane State Hospital, Gumushane, Turkey.

Department of Orthopaedics and Traumatology, Ataturk University, Erzurum, Turkey.

出版信息

Eurasian J Med. 2014 Jun;46(2):102-9. doi: 10.5152/eajm.2014.24.

Abstract

OBJECTIVE

To provide guidance in the selection of the appropriate patient for arthroscopic debridement.

MATERIALS AND METHODS

Ninety patients who were diagnosed with gonarthrosis according to modified American College of Rheumatology (ACR) criteria and who underwent arthroscopic debridement and meniscectomy were evaluated. Functional assessment of patients was made based on preoperative as well as 1 month and 1 year postoperative results of the Lysholm Knee Score and the Visual Analog Scale (VAS). One year postoperatively, the Tapper-Hoover Scoring System was used to calculate long-term results. Analyses were conducted using SPSS 18 software. For this study ethics committee approval was received from the ethics committee of Ataturk University Medical Studies Department Head on 08.10.2010 at the 6th meeting with regards to the document written on 16.06.2010 with number 998.

RESULTS

Differences between preoperative and 1-month and 1-year postoperative values in the Western Otorino and McMaster Universities Osteoarthrosis (WOMAC) Index, Lysholm and VAS were found to be statistically significant (p<0.001) (Table 1). According to Tapper-Hoover results, 82.8% of patients benefited from arthroscopic debridement in the long term (Table 2). Among body mass index (BMI) groups, the WOMAC, Lysholm and VAS values of obese patients were worse than those of normal weight and underweight patients, and the difference was statistically significant (p<0.005). Late-term results of patients younger than 55 were superior to those over 55.

CONCLUSION

In the treatment of patients with gonarthrosis, arthroscopic debridement is a good option. Patients who have a low BMI and are younger than 55 years old experience more benefit from arthroscopic debridement.

摘要

目的

为关节镜清创术合适患者的选择提供指导。

材料与方法

对90例根据改良美国风湿病学会(ACR)标准诊断为膝骨关节炎且接受关节镜清创术和半月板切除术的患者进行评估。基于Lysholm膝关节评分和视觉模拟量表(VAS)的术前以及术后1个月和1年的结果对患者进行功能评估。术后1年,使用Tapper-Hoover评分系统计算长期结果。使用SPSS 18软件进行分析。本研究于2010年10月8日在阿塔图尔克大学医学研究部主任伦理委员会第6次会议上获得伦理委员会批准,涉及2010年6月16日编号为998的文件。

结果

发现西奥蒂诺和麦克马斯特大学骨关节炎(WOMAC)指数、Lysholm评分和VAS的术前与术后1个月及1年的值之间存在统计学显著差异(p<0.001)(表1)。根据Tapper-Hoover结果,82.8%的患者从关节镜清创术中获得了长期益处(表2)。在体重指数(BMI)组中,肥胖患者WOMAC、Lysholm和VAS值比正常体重和体重过轻患者差,差异具有统计学意义(p<0.005)。55岁以下患者的晚期结果优于55岁以上患者。

结论

在膝骨关节炎患者的治疗中,关节镜清创术是一个不错的选择。BMI低且年龄小于55岁的患者从关节镜清创术中获益更多。

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1
Associations of body mass index with meniscal tears.
Am J Prev Med. 2005 May;28(4):364-8. doi: 10.1016/j.amepre.2005.01.013.
4
Arthroscopic treatment of osteoarthritis of the knee.膝关节骨关节炎的关节镜治疗
J Bone Joint Surg Am. 2003 Feb;85(2):381. doi: 10.2106/00004623-200302000-00031.

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