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膝关节镜清理术联合髌周去神经术对膝骨关节炎患者膝关节功能恢复的影响。

Effect of knee arthroscopic debridement combined with peripatellar denervation on restoration of knee function in patients with knee osteoarthritis.

机构信息

Department of Bone Trauma and Arthrology, Huai'an Hospital, No. 19, Shanyang Avenue, Huai'an District, Huai'an, 223200, Jiangsu Province, China.

出版信息

BMC Surg. 2023 Aug 11;23(1):229. doi: 10.1186/s12893-023-02113-4.

Abstract

BACKGROUND

This research examines knee osteoarthritis (OA), a prevalent orthopedic disease marked by cartilage degeneration and chronic synovitis, leading to pain, restricted mobility, and eventual loss of knee function. Notably, patellofemoral osteoarthritis constitutes a significant proportion of knee OA cases. Our study aims to assess the impact of knee arthroscopic debridement coupled with peripatellar denervation on restoring knee function in OA patients and analyze the risk factors affecting treatment outcomes. By doing so, we hope to contribute to the informed selection of clinical treatment plans, addressing a disease that, if untreated, significantly impairs patients' quality of life.

METHODS

A total of 211 patients with knee osteoarthritis treated in our hospital from June 2020 to June 2022 were analyzed retrospectively. Among them, 116 patients received arthroscopic knee debridement treatment alone as the control group, and 95 in the observation group were combined with denervation treatment based on the control group. The clinical efficacy of the two groups of patients after treatment was evaluated, and patients' pain was counted using the pain visual analogue score (VAS) method. The knee range of motion (ROM) was used to count the mobility of the patients and to compare the operative time, intraoperative perfusion volume, and length of stay between the two groups. According to the effectiveness after treatment, patients were divided into the improvement group (effective + markedly effective) and the non-improvement group, and the risk factors affecting the clinical efficacy of patients after treatment were analyzed by logistic regression.

RESULTS

The total treatment efficiency of patients in the control group was lower than that of those in the observation group (P < 0.05). There was no difference in intraoperative perfusion volume and length of stay between patients in both groups (P > 0.05). However, the operative time was shorter in the control group compared with that in the observation group (P < 0.001). The post-treatment VAS scores of patients in the observation group were lower than those in the control group, while the ROM scores were higher than those of the control group (P < 0.001). Age, BMI, and preoperative VAS score were found to be independent risk factors for patient outcome by logistic regression analysis (P < 0.05).

CONCLUSION

knee arthroscopic debridement combined with peripatellar denervation has a significant improvement in the restoration of knee function in patients with knee osteoarthritis and reduces their level of pain.

摘要

背景

本研究探讨了膝骨关节炎(OA),这是一种常见的骨科疾病,其特征为软骨退化和慢性滑膜炎,导致疼痛、活动受限以及最终膝关节功能丧失。值得注意的是,髌股关节炎构成了膝 OA 病例的重要部分。我们的研究旨在评估膝关节镜下清理术联合髌周去神经术对 OA 患者膝关节功能恢复的影响,并分析影响治疗效果的相关因素。通过这样的研究,我们希望能够为临床治疗方案的选择提供参考,从而改善这一疾病对患者生活质量的影响。

方法

回顾性分析 2020 年 6 月至 2022 年 6 月在我院接受治疗的 211 例膝骨关节炎患者,其中 116 例患者仅接受膝关节镜清理术治疗作为对照组,95 例患者在对照组的基础上结合去神经术治疗作为观察组。评估两组患者治疗后的临床疗效,并采用疼痛视觉模拟评分(VAS)法对患者的疼痛情况进行计数,使用膝关节活动度(ROM)计数患者的活动能力,并比较两组患者的手术时间、术中灌注量和住院时间。根据治疗后的效果,将患者分为改善组(有效+显效)和未改善组,采用 logistic 回归分析影响患者治疗后临床疗效的相关因素。

结果

对照组患者的总治疗有效率低于观察组(P<0.05)。两组患者的术中灌注量和住院时间无差异(P>0.05)。然而,对照组患者的手术时间短于观察组(P<0.001)。观察组患者治疗后的 VAS 评分低于对照组,ROM 评分高于对照组(P<0.001)。通过 logistic 回归分析发现,年龄、BMI 和术前 VAS 评分是影响患者预后的独立危险因素(P<0.05)。

结论

膝关节镜下清理术联合髌周去神经术可显著改善膝骨关节炎患者膝关节功能的恢复,降低其疼痛程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10422829/7837780874c7/12893_2023_2113_Fig1_HTML.jpg

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