目的 探讨关节镜清理术配合盐酸氨基葡萄糖对膝骨关节炎的治疗作用。 方法 2009年6月－2011年6月纳入轻度膝骨关节炎（AhlbackⅠ级）患者135例，随机分成3组。A组（n=45）接受关节镜清理术治疗；B组（n=45）口服盐酸氨基葡萄糖胶囊治疗；C组（（n=45）先行关节镜清理术治疗，术后口服盐酸氨基葡萄糖胶囊。观察3组Lequesne评分和WOMAC指数，用以评价治疗效果。 结果 成功随访患者123例，随访时间8个月。治疗后各组Lequesne评分和WOMAC指数较治疗前均显著好转（P＜0.01），其中治疗后C组好转较A组和B组具有显著性（P＜0.01），但B组和C组之间差异无统计学意义（P＞0.05）。 结论 关节镜清理术配合盐酸氨基葡萄糖，较之单用关节镜清理术或盐酸氨基葡萄糖，对膝骨关节炎的治疗有更好的效果。
ObjectiveTo investigate the effect of arthroscopic debridement combined with oral glucosamine hydrochloride tablets in the treatment of knee osteoarthritis. MethodsSixty-two patients with knee osteoarthritis treated between January 2013 and April 2015 were chosen to be our research subjects. They were randomly divided into trial group (n=31) and control group (n=31). The control group was treated with arthroscopic debridement, and the trial group was given glucosamine hydrochloride tablets for treatment, apart from arthroscopic debridement. We evaluated the clinical effects by visual analogue scale (VAS) score and Lysholm knee joint function score before, and 1 week, 4 weeks, 3 months and 6 months after surgery. ResultsOne week after surgery, the VAS score and Lysholm knee joint function score were not significantly different between the two groups (P>0.05). Four weeks, 3 months and 6 months after surgery, the VAS score of the trial group was respectively 3.08±0.91, 2.46±0.87, and 1.45±0.66, and was 5.47±1.02, 3.55±1.20, and 2.37±0.53 in the control group; the Lysholm score of the trial group was 80.55±2.24, 85.35±1.79, and 89.74±4.58, respectively, and of the control group was 72.55±4.47, 74.68±2.94, and 76.69±5.63. The VAS score and the Lysholm score of the trial group were both better than those of the control group (P<0.05). ConclusionArthroscopic debridement can alleviate the symptoms of knee osteoarthritis, and oral administration of glucosamine hydrochloride tablets after surgery has obvious effects.
ObjectiveTo evaluate the effectiveness of proximal fibular osteotomy combined with arthroscopic debridement in the treatment of medial knee osteoarthritis with varus. MethodsBetween December 2013 and June 2015, 61 patients with medial knee osteoarthritis with varus were treated by arthroscopic debridment in 32 cases (group A) and by proximal fibular osteotomy combined with arthroscopic debridement in 29 cases (group B). No significant difference was found in gender, age, side, disease duration, OA stage, visual analogue scale (VAS) score, and knee society score (KSS) between 2 groups (P > 0.05). The clinical outcome was evaluated by VAS score and KSS score at 1 week, 3 months, and 12 months after operation. ResultsThe patients in 2 groups were followed up 12 months. All incisions healed by first intention. There was no significant difference in complication incidence between groups A and B (0 vs. 3.4%; χ2=0.723, P=0.432). The VAS scores were significantly decreased at 1 week, 3 months, and 12 months after operation when compared with preoperative score in 2 groups (P < 0.05). The VAS score of group A was significantly lower than that of group B at 1 week after operation (P < 0.05), but the VAS score of group A was significantly higher than that of group B at 3 months, and 12 months after operation (P < 0.05). The knee function was obviously improved in 2 groups, and the KSS scores at 1 week, 3 months and 12 months after operation were significantly better than preoperative score (P < 0.05). The KSS score of group A was significantly lower than that of group B at 3 months, and 12 months after operation (P < 0.05). ConclusionProximal fibular osteotomy combined with arthroscopic debridement can treat knee malalignment and disease in knee, it is an effective and safe method to treat the medial knee osteoarthritis with varus.