【摘要】 目的:寻找膝骨性关节炎的影像学表现和关节镜手术后疗效的相关性,对膝骨性关节炎的关节镜手术适应证进行探讨。方法:2005年8月至2008年4月,收集86例关节镜手术病例,其中男44例,女42例;年龄46～67岁,平均56.3岁。对患者膝关节核磁共振片按ICRS MR分级标准进行分级,对患者膝关节站立位X线片按K/L评分(Kellgren Lawrencegrade)标准进行分级,对所有患者进行了术后随访,时间12～30个月,随访时进行Lysholm评分。结果:86例86个膝关节,核磁共振显示关节软骨损伤4级30例,3级22例,2级20例,1级12例,0级2例,分级的均数为(2.77±1.138)级;膝关节站立位X线片显示4级0例,3级24例,2级38例,1级17例,0级7例,分度的均数为(2.13±0.67)级;术后Lysholm评分59～100分,平均(95.17±7.556)分。术后Lysholm评分与ICRS MR分级的Kendall’s相关系数为-0.089,P=0.317,无相关性;术后Lysholm评分与K/L分度的Kendall’s相关系数为-0.851,P=0.036,呈负相关。结论:术前膝关节软骨的MRI(1.5T)分级不能作为关节镜手术指征判断的金标准,术前膝关节软骨的MRI(1.5T)分级与患者术后疗效无相关性,而膝关节站立位X线片有重要的参考价值。更多还原

【Abstract】 Objective:To explore the indications of arthroscope for the treatment of knee osteoarthritis and investigate the correlation between knee osteoarthritis imaging and effects of arthroscope.Methods:From 2005.8 to 2008.4,86 patients with knee osteoarthritis underwent arthroscope examination and treatment.Among the patients,44 patients were male,and 42 patients were female,ranging in age from 46 to 67 years,averaged 56.3 years.Arthrodial cartilage of knee was graded by ICRS MR,and by Kellgern Laqrence X ray.All the patients were followed up,and the duration ranged from 12 to 30 months.The Lysholm score was evaluated at the follow up time.Results:Among 86 knees in 86 cases,cartilage injury degree of knees was graded as follows:grade 4 in 30 cases,grade 3 in 22 cases,grade 2 in 20 cases,grade 1 in 12 cases,grade 0 in 2 cases,mean grade(2.77±1.138).Postoperative Lysholm score ranged from 59 to 100,averaged(95.17±7.556),Kendall’s correlation coefficient was-0.089,P =0.317.There was no correlations between cartilage injury degree and Lysholm score.X ray of knees was graded as follows:grade 4 in 0 cases,grade 3 in 24 cases,grade 2 in 38 cases,grade 1 in 17 cases,grade 0 in 7 cases,mean grade was(2.13± 0.67),the Kendall’s correlation coefficient was-0.851 with negative correlations(P= 0.036) between postoperative Lysholm score and K/L grade.Conclusion:There is no correlation between the grade of knee cartilage injury confirmed by MRI(1.5T) and effects of arthroscopy,and the grade is not a gold standard as an operation indication in arthroscope procedure.The K/L grade in X ray had important effects.更多还原