CAJ | 학술논문

目的：综合分析关节镜微创手术治疗不同时期膝关节骨性关节炎的疗效。方法：将99例膝关节骨性关节炎患者结合Kellgren-Lawrence X线分级和Outerbridge 软骨损伤分级分为早、中、晚三期：早期36例；中期40例；晚期23例。均采用关节镜微创手术治疗。记录所有患者术前、术后1月、术后1年Lysholm膝关节功能评分并进行综合分析。结果：患者均获得1年以上随访，全体患者术前膝关节Lysholm评分为52．7±4．7，术后1月为80．0±5．5，显著高于术前（P＜0．05），术后1年为71．3±13．5，显著高于术前（P＜0．05）；早期患者术前评分为55．4±4．0，术后1月为83．3±4．8，显著高于术前（P＜0．05），术后1年为80．9±4．9，显著高于术前（P＜0．05）；中期患者术前评分为52．3±4．3，术后1月为79．6±4．7，显著高于术前（P＜0．05），术后1年为74．9±6．2，显著高于术前（P＜0．05）；晚期患者术前Lysholm评分为49．2±4．1，术后1月为75．7±4．7，显著高于术前（P＜0．05），术后1年为50．1±7．6，和术前无显著差异（P＞0．05）。结论：关节镜微创手术治疗膝关节骨性关节炎具有一定疗效，对于早、中期患者疗效较好，但对于晚期患者远期疗效欠佳。
목적：종합분석관절경미창수술치료불동시기슬관절골성관절염적료효。방법：장99례슬관절골성관절염환자결합Kellgren-Lawrence X선분급화Outerbridge 연골손상분급분위조、중、만삼기：조기36례；중기40례；만기23례。균채용관절경미창수술치료。기록소유환자술전、술후1월、술후1년Lysholm슬관절공능평분병진행종합분석。결과：환자균획득1년이상수방，전체환자술전슬관절Lysholm평분위52．7±4．7，술후1월위80．0±5．5，현저고우술전（P＜0．05），술후1년위71．3±13．5，현저고우술전（P＜0．05）；조기환자술전평분위55．4±4．0，술후1월위83．3±4．8，현저고우술전（P＜0．05），술후1년위80．9±4．9，현저고우술전（P＜0．05）；중기환자술전평분위52．3±4．3，술후1월위79．6±4．7，현저고우술전（P＜0．05），술후1년위74．9±6．2，현저고우술전（P＜0．05）；만기환자술전Lysholm평분위49．2±4．1，술후1월위75．7±4．7，현저고우술전（P＜0．05），술후1년위50．1±7．6，화술전무현저차이（P＞0．05）。결론：관절경미창수술치료슬관절골성관절염구유일정료효，대우조、중기환자료효교호，단대우만기환자원기료효흠가。
Objective:To comprehensively assess the efficacies of minimally invasive arthroscopy in treatment of osteoarthritis of knee at different stages . Methods:Ninety-nine patients with osteoarthritis of knee were divided into three groups by stages(early stage,n=36;medium stage,n=40,late stage,n=23)on the Kellgren-Lawrence Scale and the Outerbridge Scale basis,and treated with minimally invasive arthroscopy.Lysholm scoring system was used to comprehensively assess the joint function of the knee in all patients before surgery,one month and one year after the procedure,respectively.Results:All patients were followed up for more than one year,and the results showed preoperative Lysholm scores of 52.7 ±4.7 on average before surgery,80.0 ±5.5 one month after surgery,and 71.3 ±13.5 one year after operation.The scoring after surgery was significantly higher than that before surgery in general(P<0.05).By comparison of the scores at the diverse three stage of disease before operation and one month and one year after surgery,the difference was significant for the early stage(55.4 ±4.0 vs.83.3 ±4.8 and 80.9 ±4.9) and medium stage(52.3 ±4.3 vs.79.6 ±4.7 74.9 ±6.2)(P<0.05).Al-though the Lysholm scores were different one month after surgery for the late stage of disease(49.2 ±4.1 vs.75.7 ±4.7),yet the difference was not signif-icant one year after surgery(P>0.05).Conclusion:Arthroscopy of the osteoarthritic knee can be therapeutic effects to a certain degree,especially for the disease at early and medium stage,however,the effects were undesirable for the late staged disease.