Clinical Research Of Three Therapeutic Methods On Observation Of The Short-term Efficacy And Selection For Knee Osteoarthritis

Objective:To evaluate the efficacy of different treatments for different severity of knee osteoarthritis(knee osteoarthritis,KOA),and to select appropriate treatments methods for patients.Methods:A total of 136 patients(164 knees)with knee osteoarthritis who were admitted to department of Orthopedics of Shanxi Bethune Hospital from October 01,2020 to October 31,2021 and met the inclusion and exclusion criteria were selected.According to the different treatment methods,the patients were divided into conservative treatment group,arthroscopic cleaning group,and total knee arthroplasty group.WOMAC osteoarthritis Index score(mild,moderate,severe)and K-L grade of knee X-ray(grade Ⅰ,Ⅱ,Ⅲ,Ⅳ)were performed for patients in each treatment group to classify the severity of KOA.The WOMAC scores of patients with different severity in each treatment group were statistically analyzed before and after treatment to evaluate the efficacy.Results:The WOMAC score results of the conservative treatment group:For patients with WOMAC<21 and K-L grade Ⅰ,Ⅱ and Ⅲ,the WOMAC score before and after treatment was statistically significant,and the treatment was effective;For patients with 21≤WOMAC≤48 and K-L grade Ⅰ and Ⅱ,the WOMAC score before and after treatment was statistically significant,and the treatment was effective;For patients with WOMAC>48 and K-L grade Ⅱ,the WOMAC score before and after treatment was statistically significant,and the treatment was effective.For patients with WOMAC<21 and K-L grade Ⅳ,there was no significant difference in WOMAC score before and after treatment,indicating no effect of treatment.The WOMAC score results of the arthroscopic cleaning group:For patients with WOMAC<21 and K-L grade Ⅲ,the WOMAC score before and after treatment was statistically significant,and the treatment was effective;For patients with 21≤WOMAC≤48 and K-L grade Ⅱ and Ⅲ,the WOMAC score before and after treatment was statistically significant,and the treatment was effective;For patients with WOMAC>48 and K-L grade Ⅱ,the WOMAC score before and after treatment was statistically significant,and the treatment was effective.For patients with 21≤WOMAC≤48 and K-L grade Ⅳ,there was no significant difference in WOMAC score before and after treatment,indicating no effect of treatment.The WOMAC score results of the total knee arthroplasty group:For patients with WOMAC≥21 and K-L grade Ⅲ and Ⅳ,comparing the WOMAC scores before and after surgery,the difference was statistically significant and the treatment was effective.Conclusion:Patients with K-L grade Ⅰ and Ⅱ,regardless of the WOMAC score,can achieve satisfactory results through conservative treatment;Arthroscopic clearing can also achieve better results for patients with K-L Ⅱ grades and WOMAC grades of moderate and severe grades and K-L Ⅲ grades with mild and moderate WOMAC scores;For patients with K-L Ⅲ and IV grades and severe WOMAC score and K-LⅣ grade and moderate WOMAC score,only total knee arthroplasty can improve the condition;For patients with K-L Ⅲ grades and moderate WOMAC scores,considerable results can be obtained by arthroscopic clearing or total knee arthroplasty.