【摘要】 目的探讨膝关节骨性关节炎的影像学和关节镜下的分型特点及各型关节镜下的治疗原则。方法对398例(448膝)膝关节骨性关节炎患者进行影像学和关节镜下分型,根据病变累及部位分为四型:Ⅰ型髌股关节型,Ⅱ型胫股关节型,Ⅲ型髁间型,Ⅳ型混合型。根据各型特点进行有选择性、有限化的关节镜下清理术,手术包括取出游离体、修整退变剥脱的软骨、清除磨损的半月板、髁间窝成形和清除增生肥厚的滑膜组织。结果随访230例,平均15个月(10￣24个月),大多数患者临床症状减轻,关节功能改善。Lyshom评分,术后平均提高37分。结论关节镜下有选择性、有限化治疗膝关节骨性关节炎可以改善膝关节功能,延缓病程。更多还原

【Abstract】 [Objective] To discuss the classification of osteoarthritis of the knee,the principles to treat different types of the disease via arthroscope. [Methods] Cases of osteoarthritis of the knee including 448 knees of 398 patients were classified into four types on x-ray, MRI and arthroscope:Ⅰpatellofemoral type; Ⅱtibialfemoral type;Ⅲintercondylar type; Ⅳmixed type. The procedures included removal loose body, hyperplastic raw surface of degenerated cartilage and synovial membrane, repair worn meniscius, and reshaping of the intercondylar fossa. [Result] 230 patients were followed up for 15 months in average. According to Lyshom evaluation system, the preoperative score was 41 postoperative score was 78. [Conclusion] Selective and limited arthroscopyic debridement were effective methods for osteoarthritic knees and delayed the pathological process.更多还原