CAJ | 학술논문

目的：探讨关节镜下关节有限清理术治疗早中期膝骨关节炎（knee osteoarthritis， KOA）的疗效。方法2004年4月～2013年10月，对45例早中期KOA在关节镜下进行刨削清理增生肥厚的炎性滑膜组织，修平退变剥脱的软骨创面，游离体摘除，去除影响关节活动的骨赘，半月板修整或成形等，术后关节腔内注入玻璃酸钠4 ml。治疗前后采用膝关节Lysholm评分进行疗效评估。结果关节镜手术时间（从关节镜进入膝关节到开始缝合切口）为（55±15） min。术后住院时间4～10 d，平均6 d。术后均无关节感染、血管神经损伤、深静脉栓塞等并发症的发生。45例随访时间3～26个月，平均12个月，Lysholm评分由术前（45．5±6．3）分提高到（78．7±8．3）分，手术前后有统计学差异（ t＝9．841，P＝0．005）。结论关节镜下关节有限清理术联合玻璃酸钠具有创伤小，并发症少，有效缓解KOA症状，有效改善关节功能的优点，是治疗早中期KOA的有效方法。
목적：탐토관절경하관절유한청리술치료조중기슬골관절염（knee osteoarthritis， KOA）적료효。방법2004년4월～2013년10월，대45례조중기KOA재관절경하진행포삭청리증생비후적염성활막조직，수평퇴변박탈적연골창면，유리체적제，거제영향관절활동적골췌，반월판수정혹성형등，술후관절강내주입파리산납4 ml。치료전후채용슬관절Lysholm평분진행료효평고。결과관절경수술시간（종관절경진입슬관절도개시봉합절구）위（55±15） min。술후주원시간4～10 d，평균6 d。술후균무관절감염、혈관신경손상、심정맥전새등병발증적발생。45례수방시간3～26개월，평균12개월，Lysholm평분유술전（45．5±6．3）분제고도（78．7±8．3）분，수술전후유통계학차이（ t＝9．841，P＝0．005）。결론관절경하관절유한청리술연합파리산납구유창상소，병발증소，유효완해KOA증상，유효개선관절공능적우점，시치료조중기KOA적유효방법。
Objective To evaluate the clinical outcomes of arthroscopic limited debridement combined with sodium hyaluronate for early period knee osteoarthritis (KOA). Methods From April 2004 to October 2013, 45 patients with KOA were treated with arthroscopic debridement .The debridement procedures included removal of hyperplastic synovial membrane , trimming the surface of degenerated articular cartilage , taking out loose bodies , removing the osteophytes which preventing the movement of the knee, menissectomy for torn meniscus,and injecting sodium hyaluronate (4 ml) into articular cavity.The Lysholm score was used to evaluate the results before and after arthroscopy . Results The average arthroscopic time ( from arthroscope entering the knee to suturing the portal incision ) was (55 ±15) min.The length of hospital stay after operation was 4-10 d, with an average of 6 d.No joint infection, nerve and vessel injury , or deep venous thrombosis were found after operation .All the 45 patients were followed up for 3-26 months, with an average of 12 months.The Lysholm scores improved from preoperative (45.5 ±6.3) points to postoperative (78.7 ±8.3) points, with statistical difference (t=9.841, P=0.005). Conclusions Arthroscopic limited debridment combined with sodium hyaluronate has advantages of minimal invasion , fewer complications , better curative effects .It is effective in relieving KOA symptoms and improving joint functions in appropriately selected patients , being an effective therapy for early period KOA .