关节镜治疗膝关节僵硬的临床观察

发布时间：2019-01-20 11:28

【摘要】：目的：关节镜下行粘连松解术治疗膝关节僵硬的临床观察。方法：2013年3月~2014年6月在我科行关节镜下粘连松解术治疗的膝关节僵硬患者。有26例,其中因股骨下段骨折9例,髌骨骨折3例,髌骨、股骨下段双骨折1例,胫骨上段骨折1例,胫骨髁间隆突骨折2例,股骨下段、胫骨双骨折2例,关节镜下前交叉韧带重建术后1例,前、后交叉韧带开放重建术后1例,前后交叉韧带合并内侧副韧带关节镜下重建术后3例,前后交叉韧带重建合并股骨髁骨折关节镜下术后1例,软组织裂伤术后2例。所有26例患者均在关节镜下行粘连松解术治疗膝关节僵硬,术中松解髌上囊、股中间肌及髁间窝的粘连,并予以手法推拿松解,术中彻底止血。术后予以冰敷、股四头肌肌力练习及抗炎消肿等康复治疗。通过手术前后活动范围、VAS及HSS评分的比较来评估疗效。结果：本组26例患者均获得随访,随访至术后6个月。术前VAS评分为(1.46±2.04),随访结束时的VAS评分为(0.38±0.80),术后的疼痛较术前减轻(t=3.89,P0.001)。术前HSS评分为(58.08±12.07),随访结束时的HSS评分为(71.96±8.98),术后的膝关节功能较术前明显改善(t=-14.77,P0.001)。其中膝关节屈曲角度平均为(106.54±12.87)。,较术前增加57°,与术前相比有统计学差异(t=-10.72,P0.001)。1例发生骨化性肌炎,无术后切口感染、皮肤坏死、髌腱断裂等并发症。结论：关节镜手术治疗膝关节僵硬的方法具有创伤小,并发症少,临床效果好等优点,手术较安全。
[Abstract]:Objective: to observe the clinical effect of arthroscopic adhesion release in the treatment of knee joint stiffness. Methods: from March 2013 to June 2014, patients with knee joint stiffness were treated with arthroscopic adhesion release. There were 26 cases, including 9 cases of distal femur fracture, 3 cases of patellar fracture, 1 case of double fracture of distal femur, 1 case of fracture of upper tibia, 2 cases of fracture of intercondylar process of tibia, 2 cases of double fracture of lower femur and tibia. Arthroscopic anterior cruciate ligament reconstruction in 1 case, anterior and posterior cruciate ligament open reconstruction in 1 case, anterior cruciate ligament with medial collateral ligament arthroscopic reconstruction in 3 cases. Anterior cruciate ligament reconstruction with femoral condylar fracture was performed in 1 case and soft tissue laceration in 2 cases. All the 26 cases were treated with arthroscopic adhesion release. The adhesion of the superior patellar sac, medius femoris and intercondylar fossa was relieved during the operation. Postoperative ice compress, quadriceps femoris muscle strength exercise and anti-inflammatory and swelling rehabilitation treatment. The efficacy was evaluated by comparing the range of activities, VAS and HSS scores before and after surgery. Results: all 26 patients were followed up until 6 months after operation. The preoperative VAS score was (1.46 卤2.04) and the VAS score at the end of follow-up was (0.38 卤0.80). The preoperative HSS score was (58.08 卤12.07) and the HSS score at the end of follow-up was (71.96 卤8.98). The average flexion angle of knee joint was (106.54 卤12.87).,), which was 57 掳higher than that before operation. Patellar tendon rupture and other complications. Conclusion: arthroscopic treatment of knee joint stiffness has the advantages of less trauma, less complications and better clinical effect.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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