关节镜下微骨折技术联合关节内注射玻璃酸钠修复膝关节软骨缺损-东南大学学报医学版

关节镜下微骨折技术联合关节内注射玻璃酸钠修复膝关节软骨缺损

单位：南京中医药大学附属常州市中医医院骨科, 江苏常州 213003

分类号：R683

出版年·卷·期（页码）：2012·31·第二期（196-198）

摘要：

目的:评价微骨折技术(microfracture, MF)联合关节内注射玻璃酸钠修复膝关节软骨缺损的修复效果。方法:对12例股骨髁软骨缺损患者采用关节镜下MF修复,缺损面积约2.0~6.0cm²,平均3.2cm²。术后第1、2、3周患膝关节腔注射玻璃酸钠20mg,1 次·周^-1。术后随访,对比手术前后的膝关节Lysholm评分、痛觉视觉模拟评分(VAS),记录术后并发症。结果:术后随访6~36个月,平均17.5个月。最终随访Lysholm评分优2例、良6例、中3例、差1例,优良率为66.7%。术前Lysholm评分(46.2±3.6)分,随访终末时为(78.4±4.9)分,差异具有统计学意义(P<0.01)。术前VAS为(4.26±0.56)分,终末随访时为(1.82±0.14)分, 差异具有统计学意义(P<0.05)。9例并发关节腔积血,2例有关节轻度疼痛和偶有交锁。结论:MF联合术后关节内注射玻璃酸钠对膝关节软骨损伤的修复效果较满意,是一种操作简单、实用的软骨修复技术。

Objective: To evaluate the treatment of knee chondral defect by microfracture (MF) technique in combination with intraarticular hyaluronic acid sodium injection. Methods: Twelve chondral defect patients on the femoral condyles were treated by MF under arthroscopy, with defect area 2.0-6.0 cm², average 3.2 cm². Postoperative 3 weeks all cases receive intraarticular injections of 20 mg hyaluronic acid sodium weekly. And the cases were followed up, the knee Lysholm scores, visual analog scores (VAS) and complications were observed. Results: All the patients were followed up for 6 to 36 months (means 17.5 months). Two cases were rated as excellent, 6 as good, 3 as fair and 1 poor, the excellent-good rate was 66.7% of the ultimate knee Lysholm scores. The ultimate knee Lysholm scores and VAS were significantly better than preoperative . Nine patients had hematoma in knee joint capsule, two cases had slight joint pain and clicked occasionally. Conclusion: MF in combination with intraarticular hyaluronic acid sodium injection has good effect for chondral lesion on femoral condyles, which is one kind of uncomplicated and practical method for cartilage restoration.

参考文献：

[1] STEADMAN J R,RODKEY W G,RODRIGO J J.Microfracture:surgical technique and rehabilitation to treat chondral defects[J].J Clin Orthop and Relat Res,2001,391s:s362-s369.
[2] 郭亭,赵建宁.关节软骨损伤与修复机制[J].临床骨科杂志,2003,6(4):380-383.
[3] STEADMAN J R,RODKEY W G,BRIGGS K K.Microfracture chondroplasty:indications,techniques,and outcomes[J].Sports Med Arthrosc Rev,2003,11(4):236-244.
[4] KANG S W,BADA L P,KANG C S,et al.Articular cartilage regeneration with microfracture and hyaluronic acid[J].Biotechnol Lett,2008,30(3):435-439.
[5] LEGOVIC D,ZORIHIC S,GULAN G,et al.Microfracture technique in combination with intraarticular hyaluronic acid injection in articular cartilage defect regeneration in rabbit model[J].Coll Antropol,2009,33(2):619-623.
[6] STRAUSS E,SCHACHTER A,FRENKEL S,et al.The efficacy of intra-articular hyaluronan injection after the microfracture technique for the treatment of articular cartilage lesions[J].Am J Sports Med,2009,37(4):720-726.
[7] ASIK M,CIFTCI F,SEN C,et al.The microfracture technique for the treatment of full-thickness articular cartilage lesions of the knee: midterm results[J].Arthroscopy,2008,249(11):1214-1220.

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