Clinical Analysis Of Arthroscopic Circumpatellar Denervation Combined With Microfracture Technique In The Treatment Of Patellofemoral Arthritis

Patellofemoral arthritis is one of the most common causes of pain in the anterior knee.About 49% of patients with osteoarthritis of the knee suffer from patellofemoral osteoarthritis.Most patients complained of pain around the patella,especially when the patellofemoral joint have a high stress.Some patients have mild symptoms,but the majority of patients will appear more severe pain that seek surgical treatment.Patellofemoral microfracture technique and circumpatellar denervation are commonly used to treat various patellofemoral arthritis.Now many experts agree that the high pressure in the patellofemoral joint is the mechanical factors leading to patellofemoral joint disease.Arthroscopic microfracture surgery is a minimally invasive surgery,having the characteristics of economy,fast,convenient,accurate and safe,and can prevent postoperative bleeding,retained the opportunity to re-surgical treatment,etc.,with the patellar denervation Surgical treatment of patellofemoral arthritis,knee pain can get better results.ObjectiveThis study is to investigate the effect of arthroscopic circumpatellar denervation combined with microfracture technique in the treatment of different degree of cartilage injury of patellofemoral arthritis.MethodsFrom January 2012 to January 2016,68 cases of arthroscopic cartilage injury Outerbridge grade ? ~ ? grade patellofemoral arthritis with anterior knee pain patients met the inclusion criteria were selected from our Orthopaedics.According to the level of cartilage injury,patients were divided into two groups,grade ? and ? grade group.Two groups were first routine microscopic exploration and clearance after into the joint cavity,and then applied the radio-frequency ablation of the patellar peripheral nerve depolarization treatment,when the defect area less than 4 cm~2 of the patellofemoral joint cartilage was confirmed,we would carry out a microfracture treatment.The patients were treated with the same routine treatment and effective rehabilitation exercise.Patients were followed up for at least 12 months.Lysholm score and VAS pain score were compared between the two groups before surgery,3 months after surgery,6 months after surgery and 12 months after surgery respectively,and the statistical analysis was performed.We observed and recorded the results of treatment and satisfaction of the patients after surgery.Using statistical software for processing,measurement data comparison using T test,the rate of comparison using ?~2 test,P <0.05 was statistically significant for the difference.Results1?There were no significant difference between the two groups in general data,Lysholm score and VAS score(P> 0.05).2?The VAS scores of both groups decreased with the increase of follow-up time,there were significantly decreased at 3 months after surgery in both two groups,and the difference was statistically significant(P <0.05).There were no statistically significant difference in VAS scores between two groups at 3 months,6 months and 12 months after surgery(P> 0.05).3?The Lysholm scores of both groups decreased with the increase of follow-up time,there were significantly decreased at 3 months after surgery in both two groups,and the difference was statistically significant(P<0.05).? grade group scores were higher than ? grade group,and there was statistically significant difference in Lysholm scores between two groups at 3 months,6 months and 12 months after surgery(P<0.05).4?? grade group after the surgery 12 months,the effective rate was 97.3%,Patient satisfaction was 86.5%;? grade group after the surgery 12 months,the effective rate was 80.6%,Patient satisfaction was 64.5%.? grade group were higher than ? grade group in both effective rate and satisfaction rate,and there was statistically significant difference(?~2 =4.525,P <0.05).Conclusions Arthroscopic circumpatellar denervation combined with microfracture technique in the treatment of ?~ ? grade patellofemoral arthritis patients with anterior knee pain can alleviate the clinical symptoms and improve the function of the knee joint effectively,and the patients' satisfaction is high after surgery.For the Outerbridge grade? patellofemoral arthritis patients with anterior knee pain,it has a better therapeutic meaning.