关节镜下微骨折术治疗老年膝关节软骨损伤的效果及其影响因素

乔建强

（延安市博爱医院，陕西 延安，716000）

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摘要：

目的 探讨老年膝关节软骨损伤采用关节镜下微骨折术治疗的效果及影响因素。方法 选择我院收治的老年膝关节软 骨损伤患者50 例，均采用关节镜下微骨折术治疗，观察临床治疗效果，并按临床治疗效果分为改善组和未改善组，对临床治 疗效果的影响因素进行单因素及多因素分析。结果 50 例老年膝关节软骨损伤患者的改善率为80.00%，与手术前比较，患者 的HSS 及Tegner 评分均明显升高（P<0.05）。改善组和未改善组患者在年龄、病程、病因、软骨缺损面积、半月板损伤、软骨损 伤程度、术后并发症方面差异具有统计学意义（P<0.05）；Logistic 回归分析结果显示，年龄跃70 岁、病程跃12 个月、有外伤、软骨 缺损面积跃4 cm2、合并半月板损伤、软骨损伤程度芋级+郁级、术后合并并发症为影响关节镜下微骨折术治疗老年膝关节软 骨损伤临床效果的独立危险因素（P<0.05）。结论 老年膝关节软骨损伤患者采用关节镜下微骨折术治疗，可明显改善患者的 膝关节功能及运动能力，但临床效果的影响因素多样，需针对性地进行防控。

关键词：关节镜下微骨折术；老年；膝关节软骨损伤

中图分类号：R687.3 文献标志码：A文章编号：2096-1413(2018)01-0049-02

Clinical effect of microfracture surgery under arthroscopy in elderly patients with knee joint cartilage injuries and

its influencing factors
QIAO Jian-qiang
(Bo``ai Hospital of Yan``an, Yan``an 71600, China)

ABSTRACT: Objective To investigate the clinical effect of microfracture surgery under arthroscopy in elderly patients with knee joint cartilage injuries and its influencing factors. Methods Fifty elderly patients with knee joint cartilage injuries admitted in our hospital were enrolled in this study, all the patients received microfracture surgery under arthroscopy, the clinical effects were observed. All the patients were divided into improvement group and non improvement group according to the clinical effect, the single factor and multi factor analysis on the influencing factors of clinical effect were analyzed. Results The total effec tive rate was 80.00%, and the HSS and Tegner scores after operation were higher than those before operation (P<0.05). There were significant differences in age, course of disease, cause of disease, area of cartilage defect, meniscus injury, degree of car tilage injury and postoperative complications between the improvement group and the non improvement group (P<0.05). The Logistic showed that the age>70 years old, duration of disease>12 months, trauma, cartilage defect area>4 cm2, combined menis cus injury, cartilage damage grade III -grade IV and postoperative complications were independent risk factors of mi crofracture surgery under arthroscopy for elderly patients with knee joint cartilage injury (P<0.05). Conclusion Microfracture
surgery under arthroscopy in elderly patients with knee joint cartilage injuries can improve the patients`` knee joint function and exercise ability; however, the factors affecting the clinical effects are diverse, which need to be prevented and controlled.

KEYWORDS: microfracture surgery under arthroscopy; elderly; knee joint cartilage injury

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