| Objective: To evaluate the clinical effect and safety of knee joint clear operation combined with injection treatment by hyaluronan injecting into articular cavity for osteoarthritis of knee.Methods: 70 cases of knee osteoarthritis from HuBei TCM Hospital were randomized into two groups, each group has 35 cases. There are 36 females and 34 males. The eldest is 69 years, and the youngest is 37years. 9 of them have pain in both knees, 61 of them have pain only in one knee. According to the Lysholm's principle about knee's functions before the treatments, points about joint's pain: cases of group I gain average at 3.72±1.25, and cases of groupⅡgain average at 3.81±1.17: Points about joint's swelling: cases of groupⅠgain average at 0.69±0.12, and cases of groupⅡgain average at 0.72±0.13: Points about joint's total function: cases of groupⅠgain average at 42.10±6.74, and cases of groupⅡgain average at 41.75±7.22. There is not very significant difference in index between the two groups before the treatments. And according to the Kellgren-Lawrence's principle about knee's X-ray performance, groupⅠhas 9 cases in gradeⅠ, 16 cases in gradeⅡand 10 cases in gradeⅢ, groupⅡhas 8 cases in gradeⅠ, 19 cases in gradeⅡand 8 cases in gradeⅢ(cases in gradeⅣare not include during this observe). The cases of the first group were treated with joint clear operation under arthroscopy combined with injection by hyaluronan injecting into articular cavity. The patients of the second group were treated with joint clear operation under arthroscopy only. All the cases were followed up after the treatments for 4 weeks and 6 months, through the symptoms such as pain,swelling,joint functions and clinical result. The clinical result's analysis is according to the classification of《Diagnosis principle of KOA》that has been published by ARA at 1995. The data of result is evaluated and analyzed statistically.Results:1 4 weeks after treatmentPoints about joint's pain: cases of groupⅠgain average at 12.67±5.09, and cases of groupⅡgain average at 11.74±4.85, relatively there are very significant difference in index after treatments(P＜0.01). There are not significant difference in index between the two groups(P＞0.05). Points about joint's swelling: cases of groupⅠgain average at 5.12±0.18, and cases of groupⅡgain average at 4.98±0.15, relatively there are very significant difference in index after treatments(P＜0.01). There are not significant difference in index between the two groups(P＞0.05).2 6 months after treatmentPoints about joint's pain: cases of groupⅠgain average at 12.28±4.88, and cases of groupⅡgain average at 10.94±4.95, relatively there are very significant difference in index after treatments(P＜0.01). There are significant difference in index between the two groups(P＜0.05). Points about joint's swelling: cases of groupⅠgain average at 5.07±0.51, and cases of groupⅡgain average at 4.47±0.57, relatively there are very significant difference in index after treatments(P＜0.01). There are significant difference in index between the two groups(P＜0.05).3 Points of joint' function after treatments4 weeks after treatment, cases of groupⅠgain average at 59.28±4.88, and cases of groupⅡgain average at 58.14±4.95, relatively there are very significant difference in index after treatments(P＜0.01). There are significant difference in index between the two groups(P＜0.05).6 months after treatment, cases of groupⅠgain average at cases of groupⅠgain average at 56.09±6.89, and cases of groupⅡgain average at 53.84±4.97, relatively there are very significant difference in index after treatments(P＜0.01).There are very significant difference in index between the two groups(P＜0.01).4 The total marked effective rate of the first group was about 82.86%, and the total effective rate was about 94.27%. The marked effective rate of the second group was about 45.71%, and the total effective rate was about 65.71%. There are very significant difference in index between the two groups(P＜0.01). The outcome of the first group was superior to that of the second group. 5 Furthermore, the outcome is related to knee's X-ray performance. Higher grade means more affection after treatment.6 All the patients have not get side effect, such as skin allergy, during the period of the treatments.Conclusion : Knee joint clear operation combined with injection treatment by hyaluronan injecting into articular cavity is more effective and endurable than the operation only on knee osteoarthritis, especially at the affections of joint's pain and swelling. Generally, the affection is as identical as the degree of knee's X-ray performance(except degree IV). Knee joint clear operation combined with injection treatment by hyaluronan injecting into articular is so effective and safe method on knee osteoarthritis that it is worth to be popularized. |
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