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关节镜诊断和治疗膝关节骨关节炎 |
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林志雄 余楠生 卢伟杰
摘要 自1990年7月～1995年7月,作者对79例(91膝)膝关节骨关节炎(OA)患者进行关节镜检查及镜下清理术。镜检结果：23例(27膝)获得早期诊断,关节镜分级与临床表现呈正相关,与X线片改变程度的符合率较低(47.1％)。随访2～5年,平均3.9年。术后综合评估：1～2年,优良率77.2％,2年以上优良率60.8％。软骨退变程度与疗效关系:术后1～2年优良率：软骨Ⅰ度退变100％、Ⅱ度71.4％、Ⅲ度60%。2年以上优良率：Ⅰ度91.7％、Ⅱ度59.1％、Ⅲ度43.4％。作者认为关节镜检有利于膝关节OA的早期诊断,并对诊断和治疗提供更全面的信息。镜下清理术对早期OA有良好疗效,而且具有创伤小、恢复快、并发症少和可重复等优点,不失为治疗膝关节OA较为理想的手术方法。
关键词 膝关节 骨关节炎 关节镜检查
The Arthroscopic Diagnosis and Treatment of Osteoarthritis of the Knee Lin Zhixiong, Yu Nansheng, Lu Weijie. Department of Orthopaedics, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120
Abstract Arthroscopic examinations and debridements were performed on 91 knees in 79 patients with osteoarthritis (OA) of the knee between July 1990 and July 1995. Arthroscopic observation showed that 27 knees of 23 patients had early diagnosis. Arthroscopic evaluation and clinical findings were positively correlated, but there was a relatively less correlation (47.2%) between the radiographic changes and the arthroscopic findings. All the patients were followed up for 2～5 years, with an average of 3.9 years. According to a comprehensively score, the excellent and good rate was 77. 2% at one to two years and 60.8% above two years. The correlation between cartilage degenerative changes and clinical results showed that there were 100% of degree I， 71.4% of degree II and 60% of degree III changes at one to two years follow up, and there were 91.7% of degree I, 59.1% of degree II and 43.4% of degree III changes above two years. The authors concluded that the arthroscopy was a useful method for early diagnosis of OA of the knee, and it provided more overall and accurate informations for the diagnosis and treatment. Arthroscopic debridement was the first selection of the surgical treatment for early stage of Ao in knee and had the advantages of less injury, fast recovery, less complication, and was an effective method for the treatment [1] [2] 下一页
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