镜下清理与髓芯减压治疗膝骨性关节炎骨髓水肿△

Arthroscopic debridement combined with core decompression for knee osteoarthritis accompanied with bone marrow ede⁃ ma

摘要:

［目的］ 评价镜下清理联合髓芯减压治疗膝骨性关节炎 （knee osteoarthritis, KOA） 合并骨髓水肿 （bone marrow ede- ma, BME）的疗效。［方法］回顾性分析 2018 年 5 月—2020 年 5 月手术治疗 KOA 合并 BME 48 例患者的临床资料。根据医患沟通结果，26 例采用关节镜清理+细针减压 （减压组），22 例采用单纯关节镜清理 （清理组）。比较两组临床与影像资料。［结果］两组患者均顺利完成手术，随访（8.25±1.32）个月。随时间推移，两组 VAS 和 WOMAC 评分均显著降低（P<0.05）。治疗后 2 个月及末次随访时，减压组 VAS 评分、WOMAC 指数均显著优于清理组 （P<0.05）。影像方面，末次随访时两组 BME 的 WORMS 分级均较术前显著改善（P<0.05），减压组显著优于清理组（P<0.05）。［结论］髓芯减压治疗 KOA 合并 BME 能够有效缓解疼痛，改善关节功能。

Abstract:

[Objective] To evaluate the clinical outcomes of arthroscopic debridement combined with core decompression in the treat- ment of knee osteoarthritis (KOA) with bone marrow edema (BME) . [Methods] A retrospective study was conducted on 48 patients who re- ceived surgical treatment for KOA complicated with BME in our department From May 2018 to May 2020. According to doctor-patient com- munication, 26 patients were treated with arthroscopic debridement and core decompression of the BME area with fine needles (the decom- pression group) , while the remaining 22 patients were treated with arthroscopic debridement alone (debridement group) . The clinical and imaging data of the two groups were compared. [Results] All patients in both groups had operation performed successfully, and were fol- lowed up for (8.25±1.32) months. VAS and WOMAC scores in 2 groups were significantly decreased over time (P＜0.05) , which in the de- compression group proved significantly superior to the debridement group at 2 months postoperatively and the latest follow-up (P＜0.05) . In terms of imaging, the WORMS grade for BME significantly improved in both groups at the latest follow-up compared with those before oper- ation (P＜0.05) , which in the decompression group was significantly better than that in the debridement group (P＜0.05) . [Conclusion] The arthroscopic debridement combined with core decompression treatment does effectively relieve pain and improve joint function for KOA complicated with BME.