关节镜清理术联合功能锻炼治疗晚期膝骨关节炎的临床研究：一项回顾性观察性研究。

Clinical trial of arthroscopic debridement combined with functional exercise in the treatment of advanced knee osteoarthritis: A retrospective observational study.

出版信息

J Back Musculoskelet Rehabil. 2024;37(6):1673-1683. doi: 10.3233/BMR-240106.

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11613048/

Abstract

BACKGROUND

Advanced knee osteoarthritis (KOA) impacts both knees, resulting in pain, deformity, and substantial restrictions in joint mobility.

OBJECTIVE

This study aims to examine the effectiveness of combining arthroscopic debridement with functional exercise in treating advanced KOA.

METHODS

A total of 296 patients diagnosed with advanced KOA were divided into two groups: the observation group (n= 152) received arthroscopic debridement combined with functional exercise, while the control group (n= 144) underwent arthroscopic debridement only. The study compared and observed the outcomes between the two groups.

RESULTS

There were no significant differences in knee joint function, inflammation level, and oxidative stress between the two groups before treatment (P> 0.05). Following treatment for six months, the observation group exhibited significantly lower visual analog scale (VAS) score, tissue inhibitors of metalloproteinase-1 (TIMP-1), tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), matrix metalloproteinase-3 (MMP-3), and malondialdehyde (MDA) levels compared to the control group (P< 0.05). Meanwhile, the observation group showed significantly higher levels of Lysholm score, hospital for special surgery (HSS) score, range of motion (ROM) of knee, peak torque (PT) and total work (TW) for knee extension and flexion, superoxide dismutase (SOD), total antioxidant capacity (T-AOC), and glutathione (GSH) compared to the control group (P< 0.05). Besides, the effective treatment rate in the observation group was notably higher than that in the control group (80.92% vs. 69.44%, P< 0.05).

CONCLUSION

The combination of arthroscopic debridement with functional exercise is an effective treatment for advanced KOA. This approach not only enhances the function and strength of knee joint and reduces inflammatory response but also boosts the body's antioxidant capacity. The treatment exhibits encouraging outcomes and warrants broad implementation.

摘要

背景

晚期膝关节骨关节炎（KOA）会影响两个膝关节，导致疼痛、畸形和关节活动度的严重受限。

目的

本研究旨在探讨关节镜清理术联合功能锻炼治疗晚期 KOA 的疗效。

方法

共 296 例晚期 KOA 患者分为两组：观察组（n=152）采用关节镜清理术联合功能锻炼治疗，对照组（n=144）仅采用关节镜清理术治疗。比较两组治疗结果。

结果

两组治疗前膝关节功能、炎症水平和氧化应激指标比较差异无统计学意义（P>0.05）。治疗 6 个月后，观察组视觉模拟评分（VAS）、组织金属蛋白酶抑制剂-1（TIMP-1）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）、基质金属蛋白酶-3（MMP-3）和丙二醛（MDA）水平均明显低于对照组（P<0.05）；Lysholm 评分、美国特种外科医院（HSS）评分、膝关节活动度（ROM）、伸膝和屈膝峰值扭矩（PT）和总功（TW）、超氧化物歧化酶（SOD）、总抗氧化能力（T-AOC）和谷胱甘肽（GSH）水平均明显高于对照组（P<0.05）。观察组有效治疗率明显高于对照组（80.92%比 69.44%，P<0.05）。