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膝关节半月板损伤关节镜微创治疗后疼痛相关危险因素

Pain-related risk factors after arthroscopic minimally invasive treatment of meniscus injury of knee joints.

作者信息

Xu Jiang, Bian Fei

机构信息

Department of Orthopedics, Quwo County People's Hospital, Linfen, Shanxi 043400, P.R. China.

出版信息

Exp Ther Med. 2020 Sep;20(3):2317-2324. doi: 10.3892/etm.2020.8953. Epub 2020 Jun 29.

Abstract

Pain-related risk factors after arthroscopic minimally invasive treatment of meniscus injury of knee joints were explored. Altogether 42 patients (conservative group), 40 patients (open group) and 46 patients (minimally invasive group) who received conservative treatment or arthroscopic knee surgery at the Quwo County People's Hospital were selected. The clinical effects of patients in the three groups at 24 weeks after treatment were observed. The knee joint activity, the knee injury and osteoarthritis outcome score (KOOS), Lysholm knee joint function score, VAS pain score and WOMAC score were recorded before treatment, at 24 weeks after treatment and at 2 years after treatment. Complications were also recorded. The related risk factors of postoperative pain were analyzed. There was no significant difference between the short-term efficacy of conservative treatment and that of surgical treatment (P>0.05); however, the long-term improvement effect of the surgical treatment on knee joint function and pain was better (P<0.05). The short-term and long-term effects of arthroscopic surgery were close to those of the open surgery. Arthroscopic surgery had a good long-term improvement effect on knee joint function and pain (P<0.05), and the incidence of postoperative pain was low (P<0.05). The results of logistic multivariate regression analysis manifested that WOMAC score, articular cartilage injury, time of postoperative weight bearing <1 week, no postoperative cold compress and open knee surgery were independent risk factors that affected postoperative pain (P<0.05). In conclusion, arthroscopic minimally invasive treatment has a good effect on patients with meniscus injury of knee joints who fail conservative treatment. Articular cartilage injury, postoperative weight bearing, cold compress and type of operation are independent risk factors that affect postoperative pain. Clinicians should bring patient attention to the prevention of meniscus injury and further improve the efficacy of treatment.

摘要

探讨膝关节半月板损伤关节镜微创治疗后疼痛相关危险因素。选取曲沃县人民医院接受保守治疗或膝关节镜手术的42例患者(保守组)、40例患者(开放组)和46例患者(微创组)。观察三组患者治疗后24周的临床疗效。记录治疗前、治疗后24周及治疗后2年的膝关节活动度、膝关节损伤和骨关节炎疗效评分(KOOS)、Lysholm膝关节功能评分、视觉模拟评分法(VAS)疼痛评分及西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分。同时记录并发症情况。分析术后疼痛的相关危险因素。保守治疗与手术治疗的短期疗效差异无统计学意义(P>0.05);然而,手术治疗对膝关节功能和疼痛的长期改善效果更好(P<0.05)。关节镜手术的短期和长期效果与开放手术相近。关节镜手术对膝关节功能和疼痛有良好的长期改善效果(P<0.05),且术后疼痛发生率较低(P<0.05)。多因素logistic回归分析结果显示,WOMAC评分、关节软骨损伤、术后负重时间<1周、术后未行冷敷及膝关节开放手术是影响术后疼痛的独立危险因素(P<0.05)。综上所述,关节镜微创治疗对保守治疗失败的膝关节半月板损伤患者效果良好。关节软骨损伤、术后负重、冷敷及手术方式是影响术后疼痛的独立危险因素。临床医生应引起患者对半月板损伤预防的重视,进一步提高治疗效果。

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