关节镜下清理术联合透明质酸钠腔内注射治疗早中期膝关节骨关节炎的效果

The efficacy of arthroscopic debridement combined with intra-articular sodium hyaluronate injection in the treatment of early- to mid-stage knee osteoarthritis

摘要:

目的 探讨关节镜下清理术联合透明质酸钠腔内注射治疗早中期膝关节骨关节炎的效果。方法 选取2022年1月—2025年1月南京中医药大学常州附属医院92例早中期膝关节骨关节炎患者作为研究对象，按照随机数字表法分为两组，各46例。对照组接受关节镜下清理术，观察组在对照组的基础上联合透明质酸钠腔内注射治疗。治疗4周后，比较两组治疗前后膝关节液炎症因子、周径、积液厚度、步态参数及疼痛、膝关节功能评分，并统计不良反应发生率。结果 治疗后，观察组的炎症因子、膝关节周径、积液厚度及疼痛与功能评分（视觉模拟评分法、西安大略和麦克马斯特大学骨关节炎指数）均低于对照组（P <0.05），而步态参数及Lysholm膝关节评分量表评分均高于对照组（P <0.05）。与治疗前相比，两组患者上述所有观察指标均改善（P <0.05）。对照组出现3例肿胀、2例感染、2例充血、1例皮疹，观察组出现2例肿胀、1例感染、3例充血、3例皮疹。两组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 联合治疗可有效降低膝关节液炎症因子水平，改善膝关节局部肿胀积液状态与步态参数，显著缓解疼痛并提升膝关节功能，且未增加不良反应风险。

Abstract:

Objective To investigate the efficacy of arthroscopic debridement combined with intra-articular sodium hyaluronate injection in the treatment of early- to mid-stage knee osteoarthritis.Methods A total of 92 patients with early- to mid-stage knee osteoarthritis treated in our hospital from January 2022 to January 2025 were enrolled and randomly divided into two groups using a random number table method, with 46 cases in each group. The control group received arthroscopic debridement, and the observation group received arthroscopic debridement combined with intra-articular sodium hyaluronate injection. After 4 weeks of treatment, the levels of inflammatory factors in knee joint fluid, knee circumference, effusion thickness, gait parameters, pain scores, knee function scores, and adverse reactions were compared between the two groups.Results After treatment, the levels of inflammatory factors, knee circumference, effusion thickness, visual analogue scale (VAS) scores, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the observation group were lower than those in the control group (all P < 0.05), while gait parameters and Lysholm knee scoring scale scores were higher than those in the control group (both P < 0.05). Compared with before treatment, all the above indicators in both groups were significantly improved (P < 0.05). In the control group, there were 3 cases of swelling, 2 cases of infection, 2 cases of hyperemia, and 1 case of rash. In the observation group, there were 2 cases of swelling, 1 case of infection, 3 cases of hyperemia, and 3 cases of rash. There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P > 0.05).Conclusion Combined therapy can effectively reduce the levels of inflammatory factors in knee joint fluid, improve local swelling, effusion, and gait parameters, significantly relieve pain and improve knee joint function, without increasing the risk of adverse reactions.