关节镜下“四通道清理法”治疗人工膝关节置换术后关节粘连的临床疗效

摘要： 探讨关节镜下“四通道清理法”治疗人工膝关节置换术后关节粘连的适应证和临床疗效。方法 2014年3月－2017年3月该科采用关节镜下“四通道清理法”对13例人工膝关节置换术后关节粘连患者进行镜下清理松解手术。其中，男4例，女9例；年龄58～73岁，平均66.7岁。采用Lysholm评分对膝关节术前及术后功能进行评价，记录术前及术后膝关节屈伸度数。结果 随访时间6～24个月，平均13.6个月。术前平均屈曲度数为73.7°（45～90°），术后6个月随访时平均屈曲度为115.7°（97～127°）。Lysholm评分从术前平均54.0分（31～69分），提高到术后6个月时平均66.8分（51～83分）。结论 关节镜下“四通道清理法”是治疗人工膝关节置换术后关节粘连安全、有效的方法，对膝关节功能的改善疗效显著。
Abstract: To evaluate the indication and clinical effect with arthroscopy and four-channel cleaning technique to treat the joint adhesion after total knee arthroplasty. Methods From March 2014 to March 2017, 13 patients of the joint adhesion after total knee arthroplasty were treated with arthroscopy and four-channel cleaning technique. Among them, 4 males and 9 females; The average age is 66.7 years (58?~?73 years). Lysholm score was used to evaluate the preoperative and postoperative function of knee joint and to record the flexion and extension of knee joint before and after surgery. Results All the patients were follow-up for 6 to 24 months, with an average of 13.6 months after the operation. The mean knee flexion was 73.7°(45°?~?90°) before the surgery and was 115.7°(97°?~?127°) at the time of 6 months follow-up. Lysholm scored an average of 54 points (31?~?69 points) before surgery, and the average score was 66.8 (51?~?83 points) for 6 months after surgery. Conclusion Arthroscopy and “four-channel cleaning” technique is a safe and effective method to treat joint adhesion after total knee arthroplasty, and it has significant effect on the improvement of knee joint function.