Tang Bo, Zeng Xuezhu, Fan Cheng
From the Sports Medicine Center, First People's Hospital of Xining City, Xining, Qinghai, China.
J Clin Rheumatol. 2022 Jan 1;28(1):e69-e72. doi: 10.1097/RHU.0000000000001608.
The aim of this study was to compare the clinical feasibility, efficacy, and cost economics of simple drug therapy with a combination therapy of arthroscopic debridement and drug treatment of ankle acute gout arthritis.
Patients with acute ankle gout arthritis hospitalized in our department from January 2017 to August 2019 were included. Among them, 32 patients who received arthroscopic debridement in a special floating position and drug therapy were included into the observation group, and 24 patients who received drug treatment alone were included into the control group. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, the effective rate, the recurrent rate, stay of hospital, complications, and cost economics were compared between these 2 groups at postoperative 48 hours, discharge time, and 1 year.
The basic data and AOFAS ankle-hindfoot score before treatment showed no significant difference (p > 0.05) between these 2 groups. Compared with the control group, the observation group showed significantly higher AOFAS score at postoperative 48 hours (80.73 ± 9.15 vs 71.09 ± 8.54, p = 0.000), discharge time (87.73 ± 9.92 vs 77.71 ± 10.26, p = 0.000), and postoperative 1 year (85.92 ± 10.39 vs 76.36 ± 8.72, p = 0.000); lower recurrence rate (15.63% vs 25%, p = 0.382); significantly shorter length of hospitalization (4.92 ± 0.88 days vs 8.90 ± 0.73 days, p = 0.000); and significantly higher cost (¥8981.2 ± ¥740.2 vs ¥3558.3 ± ¥270.1, p = 0.000) during the discharge time.
Ankle gout arthritis could be systematically and safely managed with ankle arthroscopic technique in special floating position. In addition, compared with conservative drug therapy alone, ankle arthroscopic debridement combined with conservative drug therapy improved clinical efficacy, lowered recurrence rate, and shortened length of hospitalization.
本研究旨在比较单纯药物治疗与关节镜清创联合药物治疗踝关节急性痛风性关节炎的临床可行性、疗效及成本经济学。
纳入2017年1月至2019年8月在我科住院的急性踝关节痛风性关节炎患者。其中，32例在特殊漂浮体位下接受关节镜清创及药物治疗的患者纳入观察组，24例仅接受药物治疗的患者纳入对照组。比较两组患者术后48小时、出院时及1年时的美国矫形足踝协会（AOFAS）踝-后足评分、有效率、复发率、住院时间、并发症及成本经济学情况。
两组治疗前的基础数据及AOFAS踝-后足评分比较，差异无统计学意义（p>0.05）。与对照组相比，观察组术后48小时（80.73±9.15 vs 71.09±8.54，p=0.000）、出院时（87.73±9.92 vs 77.71±10.26，p=0.000）及术后1年（85.92±10.39 vs 76.36±8.72，p=0.000）的AOFAS评分显著更高；复发率更低（15.63% vs 25%，p=0.382）；住院时间显著更短（4.92±0.88天 vs 8.90±0.73天，p=0.000）；出院时成本显著更高（8981.2元±740.2元 vs 3558.3元±270.1元，p=0.000）。
采用特殊漂浮体位的踝关节镜技术可系统、安全地治疗踝关节痛风性关节炎。此外，与单纯保守药物治疗相比，踝关节镜清创联合保守药物治疗可提高临床疗效，降低复发率，缩短住院时间。
