Department of Orthopedics, Second Affiliated Hospital of Nanchang University, Nanchang, China.
School of Future Technology, Nanchang University, Nanchang, China.
Clin Rheumatol. 2024 Jan;43(1):443-451. doi: 10.1007/s10067-023-06737-y. Epub 2023 Aug 9.
Knee arthroscopy's efficacy in symptom improvement for knee osteoarthritis remains debated. In this study, we analyzed a multicenter database to investigate local symptom improvement.
We extracted and analyzed the data of 163 patients from the Osteoarthritis Initiative cohort who underwent unilateral knee arthroscopy (UKA) and were followed up for at least 24 months. UKA patients were matched to non-UKA patients (n = 163) according to sex, age, abdominal circumference, and Kellgren-Lawrence grade. The verified KOOS questionnaires (knee catching, locking, grinding, or clicking) and common local symptoms (frequent knee pain, aching, or stiffness) were set as outcomes. Furthermore, we built a binary logistic regression model to examine the relationship between UKA and local symptom improvement and new-onset symptoms, adjusting for conservative therapeutic covariables (injection of steroids or transparent acid into the knee joint, oral chondroitin sulfate, amino glucose, or analgesics).
Analysis showed that the UKA and non-UKA groups showed no obvious difference in the three knee symptoms, but the probability of new-onset grinding or clicking, and frequent knee pain, aching, or stiffness symptoms in the UKA group were respectively 5.82 and 5.65-fold higher than that in the non-UKA group. After analyzing conservative treatment data using a multiple imputation method, the results were consistent with previous regression analyses.
Compared to the non-UKA group, the UKA group showed no noticeable differences in the improvement of the three knee symptoms and showed an increased the probability of new-onset grinding or clicking and frequent knee pain, aching, or stiffness symptoms. Key Points • Knee arthroscopy may increase the probability of new-onset grinding or clicking and frequent knee pain, aching, or stiffness symptoms. • We found no difference in the improvement of local knee symptoms (knee catching, locking, grinding, clicking or frequent pain, aching, or stiffness) improvement between the two groups with or without knee arthroscopy.
膝关节镜治疗膝骨关节炎的疗效仍存在争议。本研究通过分析多中心数据库来探究局部症状改善情况。
我们提取并分析了来自骨关节炎倡议队列的 163 例接受单侧膝关节镜手术(UKA)且随访至少 24 个月的患者数据。UKA 患者与非 UKA 患者(n=163)按性别、年龄、腹围和 Kellgren-Lawrence 分级匹配。以 KOOS 问卷(膝关节交锁、弹响、绞锁或卡住)和常见局部症状(膝关节频繁疼痛、酸痛或僵硬)为结局。此外,我们建立了二元逻辑回归模型,以检查 UKA 与局部症状改善和新发症状之间的关系,并调整了保守治疗的协变量(膝关节内注射类固醇或透明质酸、口服硫酸软骨素、氨基葡萄糖或镇痛药)。
分析表明,UKA 组和非 UKA 组在三种膝关节症状上无明显差异,但 UKA 组新发绞锁或弹响和膝关节频繁疼痛、酸痛或僵硬症状的概率分别是非 UKA 组的 5.82 倍和 5.65 倍。使用多重插补法分析保守治疗数据后,结果与之前的回归分析一致。
与非 UKA 组相比,UKA 组在三种膝关节症状的改善方面无明显差异,新发绞锁或弹响和膝关节频繁疼痛、酸痛或僵硬症状的概率增加。关键点:膝关节镜可能会增加新发绞锁或弹响和膝关节频繁疼痛、酸痛或僵硬症状的概率。我们发现,无论是否进行膝关节镜手术,两组患者的局部膝关节症状(膝关节交锁、弹响、绞锁、卡住或频繁疼痛、酸痛或僵硬)改善情况均无差异。