Study On Knee Osteoarthritis Imaging And Step Treatment

Objective:In this study, the image of osteoarthritis of the knee were analyzed. Focusing on the knee joint loading X-ray and MRI cartilage sequence (3D-FS-SPGR sequence) and conventional MRI sequences of knee articular cartilage in sensitivity, specificity to judge whether the accuracy of the classification of image is consistent; and its significance for arthroscopic surgery, fibular osteotomy, and unicompartmental arthroplasty.Method:This study is reviewed and approvaled by Beijing Municipal Science and Technology Commission ethics committee.1. Basis by collecting patient information, medical history, physical examination, X-ray standing, MRI+SPGR scan, arthroscopic surgery cases, etc., to build the library knee osteoarthritis patients.2. The case library, collected 108 patients, male 46 cases, female 62 cases, with an average age of 53.8 years. Magnetic resonance imaging examination of the group and arthroscopic findings in patients with preoperative grade, preoperative and postoperative Lysholm review score, VAS score were compared.3. Acquisition patellofemoral arthritis cases 74 cases, 32 cases were male, female 42 cases, aged 45-61 years, mean 52 years. Clinical manifestations of recurrent knee swelling, pain, down the stairs, starting immediately squatted pain symptoms. The group was formed arthroscopic patella and patellar peripheral denervation treatment of patellofemoral arthritis. Preoperative and postoperative Lysholm score and Kujala score using efficacy were statistically evaluated and graded to assess the efficacy of post-cartilage injury.4. Select knee osteoarthritis undergoing unicompartmental arthroplasty in patients 56 cases, including 26 males and 30 females, aged 52 to 73 years, with an average age of 61.8 years. Underwent MRI of the knee, plus sweep SPGR sequence, intraoperative arthroscopic exploration results contrast with the NMR analysis, evaluation and conventional sequence SPGR cartilage injury and arthroscopic findings consistent rate, help select surgical indications.Result:a case of knee osteoarthritis library has collected 108 cases of patients with medical records.2.103 cases of postoperative follow-up were carried out, with an average 12.8 months. By preoperative Lysholm score (71.08±4.25)min to surgery (77.59±4.03) points; VAS score decreased from preoperative points (6.69+1.15) to after (5.44±0.96) points; in Ⅱ and Ⅲ grade level injury and postoperative symptoms improved significantly more than the other groups.3.70 cases were followed up for an average time of 14.8 months, the incisions healed well, no complications. Lysholm score improved from preoperative average of 73.29 points to 80.93 points postoperatively, Kujala score increased from preoperative 68.34 points to 76.48 points after cartilage damage curative effect Ⅰ-Ⅲ grade were better, worse Ⅳ stage disease had cartilage damage.4.56 knee into 336 different regions according to the articular surface of the cartilage. Accounted for 55.1 percent of normal articular surface; the performance of early osteoarthritis were 21.4%; in advanced osteoarthritis ratio of 23.5%. SPGR sequence grading cartilage damage was consistent with the diagnosis and endoscopic diagnosis of 90.18%. SPGR sequence of knee cartilage lesions show sensitivity 93.1%, specificity 98.3%, Kappa value of 0.849. T2WI sequences show the sensitivity of the knee cartilage lesions was 84.4%, specificity 96.9%, Kappa value of 0.671. SPGR sequences show articular cartilage lesions than T2WI sequence.Conclusion:a library established knee osteoarthritis cases in favor of structured data and facilitate statistical research.2. Outerbridge grade nuclear magnetic effect associated with arthroscopic surgery. Arthroscopic grade Ⅱ,Ⅲ stage osteoarthritis of the knee in patients with good long-term effect, but for patients with osteoarthritis for IV grade degeneration of articular cartilage, arthroscopic debridement of the effect is not ideal.3.arthroscopic patella and patellar peripheral denervation shaping treatment of patellofemoral arthritis can significantly relieve knee pain and improve knee function, improve quality of life and delay the process of arthritis.This operation is effective for mild to moderate patellofemoral arthritis, severepatellofemoral arthritis curative effect is poor.4.3D-FS-SPGR sequence MRI evaluation of cartilage injury with high sensitivity and specificity for cartilage damage consistent with a higher rating also can be assessed unicompartmental arthroplasty indications as preoperative screening methods.