关节镜下关节清理扩创术结合运动疗法治疗膝骨关节炎患者的临床效果评价
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摘要
目的分析采用关节镜下关节清理扩创术结合运动疗法治疗膝骨关节炎的临床效果。方法将2014年7月~2016年7月我院收治的102例膝骨关节炎患者纳入本次研究,采用随机数字表法将其均分为两组,每组51例。对照组采用关节镜下关节清理扩创术,观察组在对照组治疗基础上结合运动疗法治疗,经不同方法治疗后比较两组患者的临床治疗效果,并对预后恢复情况进行随访,分别比较两组患者在30 d、90 d及180 d后的疼痛评分及膝关节功能恢复情况。结果治疗后,观察组总有效率(92.16%)与对照组(68.63%)比较明显较高,差异有统计学意义(P<0.05);观察组患者术后30 d、90 d及180 d的疼痛评分和Lysholm膝关节功能评分情况明显优于对照组,差异有统计学意义(P<0.05)。结论对膝骨关节炎患者采取关节镜下关节清理扩创术结合运动疗法,临床效果显著,预后患者疼痛、膝关节功能恢复等情况均得到显著改善。
Objective To analyze the clinical effect of joint cleaning expansion surgery combined with exercise therapy on knee osteoarthritis under arthroscopy. Methods A total of 102 patients with knee osteoarthritis admitted in our hospital from July 2014 to July 2016 were enrolled in this study. The patients were divided into two groups by random number table method, with 51 cases in each group. The control group was treated with arthroscopic joint cleaning expansion surgery, and the observation group was given exercise therapy on the basis of the treatment of the control group. The clinical treatment effect between the two groups was compared after treatment by different methods, and the prognosis was followed up. Pain scores and knee function recovery between two groups after 30 days, 90 days and 180 days were compared and analyzed. Results After treatment, the total effective rate(92.16%) in the observation group was significantly higher than that in the control group(68.63%), and the difference was statistically significant(P<0.05). Pain score and Lysholm knee function scores on 30 d, 90 d and 180 d in the observation group after operation were significantly better than those in the control group, and the differences were statistically significant( P <0.05). Conclusion The clinical effect is significant for patients with osteoarthritis of the knee to take arthroscopic joint cleaning expansion surgery combined with exercise therapy, and the pain and knee function recovery have been significantly improved in patients after treatment.
Objective To analyze the clinical effect of joint cleaning expansion surgery combined with exercise therapy on knee osteoarthritis under arthroscopy. Methods A total of 102 patients with knee osteoarthritis admitted in our hospital from July 2014 to July 2016 were enrolled in this study. The patients were divided into two groups by random number table method, with 51 cases in each group. The control group was treated with arthroscopic joint cleaning expansion surgery, and the observation group was given exercise therapy on the basis of the treatment of the control group. The clinical treatment effect between the two groups was compared after treatment by different methods, and the prognosis was followed up. Pain scores and knee function recovery between two groups after 30 days, 90 days and 180 days were compared and analyzed. Results After treatment, the total effective rate(92.16%) in the observation group was significantly higher than that in the control group(68.63%), and the difference was statistically significant(P<0.05). Pain score and Lysholm knee function scores on 30 d, 90 d and 180 d in the observation group after operation were significantly better than those in the control group, and the differences were statistically significant( P <0.05). Conclusion The clinical effect is significant for patients with osteoarthritis of the knee to take arthroscopic joint cleaning expansion surgery combined with exercise therapy, and the pain and knee function recovery have been significantly improved in patients after treatment.
引文
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[10]全海祥,康一凡,沈国华,等.关节镜下微骨折术和关节清理术修复膝关节软骨缺失临床疗效对比研究[J].中国骨与关节损伤杂志,2016,31(10):1088-1089.
[11]王立新,杜向阳.关节镜下关节清理扩创微骨折术后配合运动疗法治疗中老年膝骨关节炎[J].临床军医杂志,2016,44(7):761-763.
[12]陈玮,龙建军,万绍勇,等.吉安市老年膝骨关节炎患者运动锻炼自我管理行为的现状及影响因素[J].中国老年学杂志,2015,35(21):6227,6229.
[13]Bennell KL,Wrigley TV,Hunt MA,et al.Update on the role of muscle in the genes and management of knee osteoarthritis[J].Rheum Dis Clin North Am,2013,39(1):145-176.
[14]胡小珍,徐守宇.膝骨关节炎运动疗法疗效的作用机制研究进展[J].风湿病与关节炎,2014,3(3):55,58.
[15]吴星火,伍振威,孟春庆,等.关节镜有限清理术治疗不同分级膝关节骨性关节炎疗效的Meta分析[J].中国内镜杂志,2015,21(6):592-597.
[16]许金海,王国栋,薛瑞瑞,等.骨通贴膏配合运动疗法治疗膝骨关节炎的随机对照临床研究[J].中国医药导刊,2015,17(12):1265,1269.
[17]冯慧,潘化平.膝骨关节炎的运动治疗现状与进展[J].中华物理医学与康复杂志,2016,38(4):313-316.
[18]Knoop J,Dekker J,van der Leeden M,et al.Is the severity of knee osteoarthritis on magnetic resonance imaging associated with outcome of exercise therapy[J].Arthritis Care Res,2014,66(1):63-68.
[19]汪凤兰,张小丽,郝晶,等.老年膝骨关节炎患者运动锻炼自我管理行为及影响因素调查[J].中国康复理论与实践,2014,20(3):295-297.
[20]龚艳菲,蔡涵,韩磊磊,等.水中运动疗法在膝骨性关节炎康复中的疗效观察[J].颈腰痛杂志,2015,36(1):55,57.
[2]Enea D,Cecconi S,Calcagno S,et al.Single-stage cartilage repair in the knee with microfracture covered with a resorbable polymerbased matrix and autologous bone marrow concentrate[J].Knee,2013,20(6):562-569.
[3]张江礼,窦珊珊,王华军,等.关节镜下有限与广泛清理术治疗不同分期膝关节骨性关节炎的疗效比较[J].中国老年学杂志,2015,35(11):3071,3073.
[4]李军,彭峥,胥方元.运动疗法治疗膝骨关节炎的研究进展[J].西南军医,2016,18(6):548-551.
[5]徐鲁.关节镜下清理术治疗膝关节骨关节炎效果分析[J].现代实用医学,2015,27(4):534-535,551.
[6]申晓坤,李发祥,王维山,等.关节镜治疗膝骨关节炎疗效影响因素的回归分析[J].局解手术学杂志,2016,25(8):585-588.
[7]Creaby MW,Wrigley TV,Lim BW,et al.Self-reported knee joint instability is related to passive mechanical stiffness in medial knee osteoarthritis[J].BMC Musculoskelet Disord,2013,14(1):326.
[8]许松涛,于之明,周炳怀.膝关节镜治疗膝骨性关节炎患者疗效的影响因素研究[J].安徽医药,2014,18(6):1114-1116.
[9]Yates AJ,Mcgrory BJ,Starz TW,et al.AAOS appropriate use criteria:Optimizing the non-arthroplasty management of osteoarthritis of the knee[J].J Am Acad Orthop Surg,2014,22(4):261-267.
[10]全海祥,康一凡,沈国华,等.关节镜下微骨折术和关节清理术修复膝关节软骨缺失临床疗效对比研究[J].中国骨与关节损伤杂志,2016,31(10):1088-1089.
[11]王立新,杜向阳.关节镜下关节清理扩创微骨折术后配合运动疗法治疗中老年膝骨关节炎[J].临床军医杂志,2016,44(7):761-763.
[12]陈玮,龙建军,万绍勇,等.吉安市老年膝骨关节炎患者运动锻炼自我管理行为的现状及影响因素[J].中国老年学杂志,2015,35(21):6227,6229.
[13]Bennell KL,Wrigley TV,Hunt MA,et al.Update on the role of muscle in the genes and management of knee osteoarthritis[J].Rheum Dis Clin North Am,2013,39(1):145-176.
[14]胡小珍,徐守宇.膝骨关节炎运动疗法疗效的作用机制研究进展[J].风湿病与关节炎,2014,3(3):55,58.
[15]吴星火,伍振威,孟春庆,等.关节镜有限清理术治疗不同分级膝关节骨性关节炎疗效的Meta分析[J].中国内镜杂志,2015,21(6):592-597.
[16]许金海,王国栋,薛瑞瑞,等.骨通贴膏配合运动疗法治疗膝骨关节炎的随机对照临床研究[J].中国医药导刊,2015,17(12):1265,1269.
[17]冯慧,潘化平.膝骨关节炎的运动治疗现状与进展[J].中华物理医学与康复杂志,2016,38(4):313-316.
[18]Knoop J,Dekker J,van der Leeden M,et al.Is the severity of knee osteoarthritis on magnetic resonance imaging associated with outcome of exercise therapy[J].Arthritis Care Res,2014,66(1):63-68.
[19]汪凤兰,张小丽,郝晶,等.老年膝骨关节炎患者运动锻炼自我管理行为及影响因素调查[J].中国康复理论与实践,2014,20(3):295-297.
[20]龚艳菲,蔡涵,韩磊磊,等.水中运动疗法在膝骨性关节炎康复中的疗效观察[J].颈腰痛杂志,2015,36(1):55,57.