摘要
背景:成年人膝关节剥脱性骨软骨炎会出现局部关节软骨与软骨下骨不稳定,如不及时治疗,将对关节软骨产生继发性影响,发生膝关节骨性关节炎的概率明显提高,目前尚缺乏明确的治疗方案。目的:探讨膝关节镜联合Herbert双向加压螺钉内固定治疗膝关节剥脱性骨软骨炎的临床疗效。方法:回顾性分析2014年6月至2018年9月接受治疗的符合膝关节剥脱性骨软骨炎诊断标准的成年人患者,并排除合并其他膝关节疾病者。接受治疗的患者有43例,其中男25例,女18例,所有患者均行膝关节镜联合Herbert双向加压螺钉内固定治疗;所有患者均为成年人,年龄18-53岁,平均为(29.00±4.62)岁;所有患者均为单侧膝关节发病,其中左侧19例,右侧24例。治疗前和末次随访时对比膝关节活动度,使用目测类比评分评估膝关节疼痛程度,膝关节Lysholm评分评价膝关节功能变化情况。结果与结论:①43例患者中有35例完成1年以上随访,随访时间为12-20个月,平均(14.0±2.5)个月,无一例患者出现相关并发症;②治疗后所有患者膝关节疼痛与功能均显著改善,治疗前膝关节活动度为(109.57±12.45)°,末次随访时膝关节活动度为(126.39±13.73)°,差异有显著性意义(t=-56.72,P<0.001);治疗前目测类比评分为(5.53±1.47)分,治疗后为(0.79±1.35)分,差异有显著性意义(t=-137.51,P<0.001);治疗前Lysholm评分为(58.27±10.51)分,治疗后为(89.36±5.43)分,差异有显著性意义(t=-163.65,P<0.001);③结果表明,应用膝关节镜联合Herbert双向加压螺钉治疗成年人膝关节剥脱性骨软骨炎固定可靠、手术创伤小,可以显著改善膝关节功能,临床疗效满意。
BACKGROUND:Osteochondritis dissecans of the knee in adults may lead to local instability of articular cartilage and subchondral bone.If it is not treated in time,it will have a secondary impact on articular cartilage,and the probability of osteoarthritis of knee joint is significantly increased.At present,there is no clear treatment plan.OBJECTIVE:To investigate the clinical effect of knee arthroscopy combined with Herbert bidirectional compression screw internal fixation for osteochondritis dissecans of the knee.METHODS:Adult patients who met the diagnostic criteria of osteochondritis dissecans of the knee from June 2014 to September 2018 were retrospectively analyzed,and those with other knee joint diseases were excluded.There were 43 patients treated,including 25 males and 18 females.All patients were treated with knee arthroscopy combined with Herbert two-way compression screw internal fixation.All patients were adults,aged 18-53 years,with an average age of(29.00±4.62)years.All patients had unilateral knee joint disease,including 19 cases of the left limb and 24 cases of the right limb.Before treatment and at final follow-up,knee motion range was compared.Visual analogue scale score was used to evaluate knee pain.Knee Lysholm score was used to evaluate knee function.RESULTS AND CONCLUSION:(1)Of the 43 patients,35 completed the follow-up time of more than 1 year,and the follow-up time was 12-20 months,with an average of(14.0±2.5)months.None of the patients had related complications.(2)Knee joint pain and function improved significantly in all patients after surgery.The mean knee motion range before operation was(109.57±12.45)°,and(126.39±13.73)°at the final follow-up(t=-56.72,P<0.001).Visual analogue scale score was(5.53±1.47)before surgery and(0.79±1.35)(t=-137.51,P<0.001)after surgery.Mean Lysholm score was(58.27±10.51)before surgery,and(89.36±5.43)postoperatively(t=-163.65,P<0.001).(3)Knee arthroscopy combined with Herbert’s two-way compression screw internal fixation for adult osteochondritis
作者
王晓非
滕学仁
丛琳岩
周旭
马振华
Wang Xiaofei;Teng Xueren;Cong Linyan;Zhou Xu;Ma Zhenhua(Dalian Medical University,Dalian 116044,Liaoning Province,China;Department of Bone,Joint and Sports Meicine,Qingdao Municipal Hospital,Qingdao 266071,Shandong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第3期397-402,共6页
Chinese Journal of Tissue Engineering Research
关键词
骨
膝关节
关节镜
内固定
螺钉
剥脱性骨软骨炎
疼痛
活动度
bone
knee joint
arthroscopy
internal fixation
screw
exfoliative chondritis
pain
motion range
