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关节镜下侧方骨减压与微骨折术治疗膝关节大面积软骨缺损的短期疗效比较
作者:董丙江  王斌  刘新晖  殷建  汪翔  贾小龙 
单位:南京医科大学附属江宁医院 骨科, 江苏 南京 211100
关键词:侧方骨减压 关节镜 软骨缺损 临床疗效 
分类号:R684
出版年·卷·期(页码):2021·49·第十一期(1277-1281)
摘要:

目的:比较分析在关节镜下分别应用侧方骨减压与微骨折术治疗膝关节大面积软骨缺损的早期临床疗效。方法:选择我院骨科自2017年2月至2019年1月收治的40例膝关节软骨缺损患者,按照手术方式不同分为两组。观察组在关节镜下行关节清理术联合侧方骨减压术,对照组在关节镜下行关节清理术联合微骨折术。比较分析两组患者的术前及术后3个月随访时的疼痛视觉模拟评分(VAS)、美国特种外科医院(HSS)评分及Tegner运动评分。结果:两组患者术前一般资料比较,差异无统计学意义(P>0.05)。两组患者术后3个月疼痛较术前均明显减轻,观察组患者VAS评分显著低于对照组[(1.65±0.75)分vs.(2.85±0.67)分,P<0.05];两组患者术后3个月HSS评分[(86.45±3.95)分vs.(84.05±3.09)分]和Tegner运动评分[(4.25±0.64)分vs.(3.70±0.66分]均较术前有明显提高且观察组高于对照组,差异均有统计学意义(均P<0.05)。结论:关节镜下侧方骨减压及微骨折术均是治疗膝关节大面积软骨缺损的有效方法。关节镜下侧方骨减压短期随访的临床疗效优于关节镜下微骨折术,其长期疗效有待进一步观察。

Objective: To compare the short-term clinical efficacy on lateral bone decompression and micro-fracture in arthroscopy for the treatment of large knee cartilage defect. Methods: 40 patients were collected in our hospital from February 2017 to January 2019.They divided into two groups according to different surgeries. The patients in observation group received the surgery of lateral bone decompression in arthroscopy and the control group received the surgery of micro-fracture in arthroscopy. The preoperative and postoperative visual analogue scale (VAS), the hospital for special surgery(HSS) score, Tegner score were recorded and compared. Results: There was no statistically significant difference in general characteristics before surgery between two groups. The VAS score, HSS score and Tegner score of two groups were improved after operation. The postoperative VAS score of the observation group was significantly lower than that of the control group (1.65±0.75 vs. 2.85±0.67). The postoperative HSS score(86.45±3.95 vs. 84.05±3.09) and Tegner score (4.25±0.64 vs. 3.70±0.66) of the observation group were significantly higher than those of the control group. Conclusion: Both lateral bone decompression and micro-fracture in arthroscopy for the treatment of large knee cartilage defect are effective. Moreover, the short-term efficiency of lateral bone decompression in arthroscopy is prior than that of micro-fracture in arthroscopy, and its long-term efficacy needs further observation.

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