关节镜清理加髌骨周围去神经化术治疗髌股关节炎的疗效观察
摘要
目的观察关节镜清理加髌骨周围去神经化术治疗髌股关节炎的疗效。方法将2016年1月至2017年10月收治的76例髌股关节炎患者,按随机数字表法随机分为对照组和治疗组,每组各38例。对照组采用关节镜清理治疗,治疗组在对照组的基础上给予髌骨周围去神经化术治疗,治疗前、术后3个月及半年采用美国西部Ontario与McMaster大学骨关节炎指数(western Ontario and McMaster University osteoarthritis index,WOMAC)评分及髌股关节功能评分(Kujala评分)评价,并记录是否有不良反应发生。结果所有患者获半年随访,对照组和治疗组在治疗结束3个月、半年后WOMAC评分均较治疗前降低,Kujala评分明显高于治疗前,差异均有统计学意义(P<0.05),且治疗组的效果优于对照组,差异有统计学意义(P<0.05);但治疗组在治疗结束3个月和半年比较,差异无统计学意义(P>0.05)。所有患者均未出现重要血管神经损伤等并发症。结论关节清理加髌骨周围去神经化术可有效缓解髌股关节炎引起的膝前疼痛,促进膝关节功能恢复,且无明显不良反应。
引文
[1]汪伍,潘惠娟,王惠芳.关节松动术联合肌力训练在髌股关节炎关节镜术后康复中的应用研究[J].中国康复医学杂志,2016,31(3):280-285.
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[3]李行星,窦强兵,王启伟,等.关节镜治疗早期膝骨关节炎疗效的影响因素分析[J].实用骨科杂志,2016,22(5):403-406.
[4] Scarpignato C,Lanas A,Blandizzi C,et al.Safe prescribing off non-steroidal anti-inflammatory drugs in patients with osteoarthritis-an expert consensus addressing benefits as well as gastrointestinaland cardiovascular risks[J].BMC Med,2015,13(1):55.
[5] Schiphof D,van Middelkoop M,de Klerk BM,et al.Crepitus is a first indication of patellofemoral osteoarthritis(and not of tibiofemoral osteoarthritis)[J].Osteoarthr Cartil,2014,22(5):631-638.
[6] Kujala UM,Jaakkola LH,Koskinen SK,et al.Scoring of patellofemoral disorders[J].Arthroscopy,1993,9(2):159-163.
[7]张民,吕智.髌股关节置换(一)[J].实用骨科杂志,2011,17(12):1150.
[8]姜德波,徐雪鹏,刘鹏,等.体外冲击波治疗创伤后髌股关节炎近期疗效观察[J].中国康复医学杂志,2016,31(3):349-351.
[9] Cicuttini FM,Wluka AE.Osteoarthritis:Is OA a mechanical or systemic disease?[J].Nature Reviews Rheumatology,2014,10(9):515-516.
[10]周英祝,王强.关节镜治疗轻中度髌股关节炎疗效探讨[J].实用骨科学杂志,2012,18(8):704-706.
[11] Rodriguez-Merchan EC.Surgical treatment of isolated patellofemoral osteoarthritis[J].HSSJ,2014,10(1):79-82.
[12]程锐,高兴华,侯之启.人髌周组织神经末梢分布的组织形态学观察[J].中华骨科杂志,2013,33(11):1120-1125.
[13]肖春苟,邓雪华,张小花,等.选择性切断膝关节神经支对膝骨性关节炎模型兔关节软骨超微结构的影响[J].解剖学研究,2013,35(6):418-421.
[14]周洋,王靖,朱旻宇,等.去神经化术在髌股关节炎膝前痛治疗中的应用[J].中国内镜杂志,2017,23(10):53-57.
[2] Wyndow N,Collins N,Vicenzino B,et al.Is there a biomechanical link between patellofemoral pain and osteoarthritis?a narrative review[J].Sports Med,2016,46(12):1797-1808.
[3]李行星,窦强兵,王启伟,等.关节镜治疗早期膝骨关节炎疗效的影响因素分析[J].实用骨科杂志,2016,22(5):403-406.
[4] Scarpignato C,Lanas A,Blandizzi C,et al.Safe prescribing off non-steroidal anti-inflammatory drugs in patients with osteoarthritis-an expert consensus addressing benefits as well as gastrointestinaland cardiovascular risks[J].BMC Med,2015,13(1):55.
[5] Schiphof D,van Middelkoop M,de Klerk BM,et al.Crepitus is a first indication of patellofemoral osteoarthritis(and not of tibiofemoral osteoarthritis)[J].Osteoarthr Cartil,2014,22(5):631-638.
[6] Kujala UM,Jaakkola LH,Koskinen SK,et al.Scoring of patellofemoral disorders[J].Arthroscopy,1993,9(2):159-163.
[7]张民,吕智.髌股关节置换(一)[J].实用骨科杂志,2011,17(12):1150.
[8]姜德波,徐雪鹏,刘鹏,等.体外冲击波治疗创伤后髌股关节炎近期疗效观察[J].中国康复医学杂志,2016,31(3):349-351.
[9] Cicuttini FM,Wluka AE.Osteoarthritis:Is OA a mechanical or systemic disease?[J].Nature Reviews Rheumatology,2014,10(9):515-516.
[10]周英祝,王强.关节镜治疗轻中度髌股关节炎疗效探讨[J].实用骨科学杂志,2012,18(8):704-706.
[11] Rodriguez-Merchan EC.Surgical treatment of isolated patellofemoral osteoarthritis[J].HSSJ,2014,10(1):79-82.
[12]程锐,高兴华,侯之启.人髌周组织神经末梢分布的组织形态学观察[J].中华骨科杂志,2013,33(11):1120-1125.
[13]肖春苟,邓雪华,张小花,等.选择性切断膝关节神经支对膝骨性关节炎模型兔关节软骨超微结构的影响[J].解剖学研究,2013,35(6):418-421.
[14]周洋,王靖,朱旻宇,等.去神经化术在髌股关节炎膝前痛治疗中的应用[J].中国内镜杂志,2017,23(10):53-57.