Yuan Yi, Zhang Hai-Jun, Zhang Bo, Luo Hao, Yang Chao
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China.
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China;
Zhongguo Gu Shang. 2017 Apr 25;30(4):300-303. doi: 10.3969/j.issn.1003-0034.2017.04.003.
To evaluate the curative effect of arthroscopy-assisted irrigation with different times for the treatment of suppurative knee arthritis in elder patients.
From October 2012 to October 2014, 23 old patients with suppurative knee arthritis were treated with arthroscopic debridement and continuous irrigation. All the patients were randomly divided into two groups:one-week irrigation group (10 cases) and two-week irrigation group(13 cases). The ESR, CRP, recovery time of knee skin temperature, joint rang of motion and knee function were observed to evaluate the therapeutic effects.
All the patients were followed up, and the mean duration was(13.3±2.3) months. No recurrence was observed. The CRP in both groups returned to normal level 2 weeks after operation. The ESR in two-week irrigation group returned to normal level 2 weeks after operation, while in one-week irrigation group it was still at a high level, and returned to normal level 3 weeks after operation; there was a statistical significance between these two groups(<0.05). The recovery time of knee skin temperature after operation in two-week irrigation group was (13.4±1.2) d on average(ranged, 8 to 17 d), which was less than(15.5±1.9) d on average(ranged, 10 to 20 d) in one-week irrigation group (<0.05). The knee joint mobility of all patients 1, 3, 6 months after operation was significantly improved compared with those before surgery(<0.05). The knee joint mobility of patients in two-week irrigation group was better than that in one-week irrigation group at the first month after operation(<0.05);but there were no significant differences between these two groups 3, 6 months after operation. The Lysholm score of all patients 1, 3, 6 months after operation was significantly improved compared with those before surgery(<0.05). The Lysholm score of patients in two-week irrigation group was better than in one-week irrigation group at the first month after operation(<0.05);but there were no significant differences between these two groups 3, 6 months after operation. All the patients had stable knee functions 3 months after operation. According to the Lysholm scale, 3 patients got an excellent result, 6 good and 1 poor in one-week irrigation group 6 months after operation;5 patients got an excellent result, 7 good and 1 poor in two-week irrigation group;there was no significant differences between these two groups.
Treatment of suppurative knee arthritis using arthroscopy has such advantages as minimal invasion and complete debridement, which is helpful to attenuate inflammation and regain knee function. It is suggested that the irrigation should be prolonged for two weeks postoperatively.
评估关节镜辅助下不同冲洗时间治疗老年化脓性膝关节炎的疗效。
2012年10月至2014年10月，对23例老年化脓性膝关节炎患者行关节镜下清创及持续冲洗治疗。所有患者随机分为两组：一周冲洗组（10例）和两周冲洗组（13例）。观察血沉（ESR）、C反应蛋白（CRP）、膝关节皮肤温度恢复时间、关节活动度及膝关节功能，以评估治疗效果。
所有患者均获随访，平均随访时间为（13.3±2.3）个月，无复发。两组患者术后2周CRP均恢复至正常水平。两周冲洗组术后2周ESR恢复至正常水平，而一周冲洗组术后2周ESR仍处于较高水平，术后3周恢复至正常水平；两组间差异有统计学意义（<0.05）。两周冲洗组术后膝关节皮肤温度恢复时间平均为（13.4±1.2）天（范围8至17天），短于一周冲洗组的平均（15.5±1.9）天（范围10至20天）（<0.05）。所有患者术后1、3、6个月膝关节活动度较术前均有明显改善（<0.05）。术后第1个月，两周冲洗组患者膝关节活动度优于一周冲洗组（<0.05）；但术后3、6个月两组间差异无统计学意义。所有患者术后1、3、6个月Lysholm评分较术前均有明显改善（<0.05）。术后第1个月，两周冲洗组患者Lysholm评分优于一周冲洗组（<0.05）；但术后3、6个月两组间差异无统计学意义。所有患者术后3个月膝关节功能稳定。根据Lysholm评分标准，术后6个月一周冲洗组3例优，6例良，1例差；两周冲洗组5例优，7例良，1例差；两组间差异无统计学意义。
关节镜治疗化脓性膝关节炎具有创伤小、清创彻底等优点，有助于减轻炎症，恢复膝关节功能。建议术后冲洗时间延长至两周。
