Effect Of Arthroscopic Intercondylar Fossa Enlargement Rate On The Efficacy Of Intercondylar Fossa Impingement Syndrome

Background: The knee joint is an exercise and load-bearing joint that is used more frequently in the daily life of the human body.Because of this feature,it also becomes one of the more vulnerable joints.Meniscus and anterior cruciate ligament are the most common anatomical structures that are prone to tear.And as the age increases,the probability of injury to the components of the knee joint will also increase.ACL is an important tough structure to maintain the stability of knee joint function.Once ACL is damaged or broken,it will cause local pain or even inactivity,which will greatly affect the quality of daily life.Intercondylar fossa impingement syndrome is a morbid syndrome in which knee joints undergo friction and impact with ACL during flexion and extension of the knee joint.Local swelling of the knee joint,repeated fluid accumulation,pain,and restricted extension are common clinical symptoms.There is no unified conclusion on the pathogenesis of the intercondylar fossa impingement syndrome.A large number of studies have shown that knee osteoarthritis may be an important cause,and with the aggravation of osteoarthritis,it will not only affect the quality of life of patients,but may also cause disability therefore,early intervention of chronic knee injury is of great significance for preserving knee function and improving patients’ quality of life.Purpose: To explore the correlation between the enlargement rate of the intercondylar fossa after the intercondylar fossa plasty and the postoperative efficacy.Methods: The medical records of patients under arthroscopy intercondylar fossa plasty due to the intercondylar fossa impingement syndrome from September 2017 to September 2019 were collected.Twenty patients were selected for follow-up according to the inclusion and exclusion criteria.There are 10 males and 10 females,11 left knees and 9 right knees.The main clinical symptoms are knee pain,locking sensation,limitedmovement,and unstable knee joints.Among them,12 patients had lock sensation in daily life,16 patients had pain that significantly affected their lives or work,and 7 patients had meniscus injury,aged 35-70 years.Intercondylar fossa plasty was performed in our hospital.MRI was performed before and after the operation.The width of the intercondylar fossa and the width of the femoral condyles were measured.The VAS score and Lysholm score were used to evaluate the efficacy.After data collection,SPSS 23.0 software was used for statistical analysis.Results: All 20 patients were followed up.All patients were evaluated for efficacy 3 months after surgery.The average width of the intercondylar fossa was 17.27±0.78 mm before surgery and 21.13±1.01 mm after surgery.The average notch width index was 0.21±0.0078 before surgery and 0.26±0.0186 after surgery,the width of intercondylar fossa was significantly wider than before,and the difference was statistically significant(P <0.01).The average VAS score was 7.50±0.61 before surgery and 2.45±0.76 after surgery,postoperative knee pain was significantly less than that before surgery(P<0.01).The preoperative Lysholm score was 67.10±4.14 and the postoperative score was 82.70±6.10,the joint function was significantly improved compared with that before surgery(P <0.01).The enlargement rate of the intercondylar fossa in all cases was between0.01-0.13,divided into 3 groups(0.01-0.05,0.05-0.09,0.09-0.13),and the efficacy was divided into three grades(“excellent”,“good”,“average”)according to the changes in Lysholm score before and after surgery,of which enlargement rate of the intercondylar fossa was “0.05--0.09” in 7 patients with“excellent” efficacy,1 patients with “good” efficacy,0 patients with “average”efficacy;And enlargement rate of the intercondylar fossa was “0.01--0.05”,3patients with “good” efficacy,3 patients with “average” efficacy;And enlargement rate of the intercondylar fossa was “0.09--0.13”,2 patients with“good” efficacy and 4 patients with “average” efficacy.Using Fisher’s exact test,the efficacy of postoperative enlargement rate of the intercondylar fossa of“0.05--0.09” was better than that of the other two groups,with statisticallysignificant differences(P <0.01).In all cases,there was very little intraoperative bleeding,short operation time,no wound infection,no hematoma,and no deep vein thrombosis.Conclusion: Intercondylar fossa plasty with minimal trauma and rapid recovery is safe and effective for patients with the intercondylar fossa impingement syndrome.The enlargement rate of the intercondylar fossa is0.05-0.09,and the postoperative efficacy is the best,which provides a reference value for the clinical practice of this operation.