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OBJECTIVE@#To assess the therapeutic effect of hyaluronate acid (HA) injection through the subpatellar route for treatment of chondromalacia patellae (CP).@*METHODS@#Eighty-eight patients with the diagnosis of CP were enrolled in this prospective study, including 38 with early CP (CP group) and 50 with advanced CP (patellofemoral arthritis group) diagnosed based on image presentations. All the patients received intra-articular HA injections through a subpatellar route once a week for 5 consecutive weeks. The primary outcome measures included WOMAC index scores and Lequesne scores before and at 4, 12, 26 and 52 weeks after the injections. The secondary outcome measures included the 30-m walking time and stair ascending and descending time (one floor) before and at 1, 2, 3, and 4 weeks after the injections.@*RESULTS@#In both groups the patients showed significantly decreased WOMAC scores and Lequesne scores at 4, 12, 26 and 52 weeks after HA injections as compared with the baseline scores (all < 0.01). No significant difference was found between the two groups in WOMAC scores and Lequesne scores at 4 or 12 weeks after the injections (both >0.05). The WOMAC scores and Lequesne scores at 26 and 52 weeks after the injections were significantly higher in patellofemoral arthritis group than in CP group (both < 0.05). In both groups, the 30-m walking time and the stair ascending and descending time decreased significantly at 1, 2, 3, and 4 weeks after HA injections (all < 0.05) without significant differences between the two groups (all >0.05).@*CONCLUSIONS@#HA injection through the subpatellar route is effective for treatment of CP. HA injection produces better long-term efficacy for treatment of early CP than for advanced CP where patellofemoral arthritis occurs.
Subject(s)
Humans , Chondromalacia Patellae , Follow-Up Studies , Hyaluronic Acid , Injections, Intra-Articular , Osteoarthritis, Knee , Pain Measurement , Prospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Objective To investigate the clinical effect of arthroscopic debridement combined with patellofemoral peripheral denervated operation in treating patellofemoral arthritis.Methods One hundred cases of patellofemoral arthritis anterior knee pain in this hospital from January 2014 to September 2015 were selected and randomly divided into the observation group and control group,50 cases in each group.The control group was given the arthroscopic debridement treatment,while the observation group was given the arthroscopic debridement combined with patellofemoral peripheral denervated operation.The visual analogue scale (VAS) before and after treatment,and Lysholm and Kujala scores after treatment were compared between the two groups.Results There was no statistically significant difference in the VAS score before treatment between the two groups (P＞0.05).After treatment,the VAS score in the two groups were significantly decreased,moreover the VAS score in the observation group was lower than that of the control group (P＜0.05).After treatment,the Lysholm scores in the observation group and the control group were (80.93±4.21) points and (74.29±4.48) points,the knee Lysholm scores of claudication,joint noose,bearing weight,pain,instability,up and down stairs,jump,run,joint swollen and pain,squats were significantly better than those in the control group (P＜0.05);aftertreatment,the Kujala total score in the observation group and the control group were (76.48±6.54) points and (68.34-±-6.22) points respectively,the Kujala scores of claudication,walking distance,bearing weight,squat,up and down stairs,jumping,running,knee pain,long time kneebend,abnormal patellofemoral activity,anterior knee swelling,knee bending limitation,thigh muscle atrophy in the observation group were significantly better than those in the control group(P＜0.05).Conclusion Arthroscopic debridement combined with patellofemoral peripheral denervation surgery in the treatment of patellofemoral osteoarthritis can obviously relieve pain and improves the knee function and patellofemoral joint function.
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Objective To investigate the curative effect of knee arthroplasty combined with denervation technique on knee patellofemoral arthropathy. Methods 60 patients with patellofemoral arthritis were selected from September 2009 to September 2015 for the study. All the patients were divided into observation group and control group by random number table. The patients in the control group were treated with arthroscopic treatment, and the patients in observation group were treated with arthroscopic cleaning and patellar biotherapy. The WOMAC score, the Lysholm score, and the Kujala score were compared between the two groups before and 3 months after surgery. Results There was no significant difference between the preoperative observation group and the control group (P > 0.05). The scores of WOMAC score, Lysholm score and Kujala score were higher in the observation group and the control group than those before the control group (P < 0.05 ). There were 2 cases of infection and 1 case of vascular nerve injury in 30 cases of postoperative 3 m observation group. One case of infection and 1 case of joint activity were restricted in 30 cases of control group. There was no significant difference in postoperative adverse reaction between the two groups (P > 0.05). Conclusions Given patellofemoral arthritis knee arthroplasty arthroscopy combined with patellar percutaneous nerve treatment can relieve pain, improve patellofemoral function and clinical efficacy, can be further popularized and used in clinical practice.
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Objective To investigate the curative effect of knee arthroplasty combined with denervation technique on knee patellofemoral arthropathy. Methods 60 patients with patellofemoral arthritis were selected from September 2009 to September 2015 for the study. All the patients were divided into observation group and control group by random number table. The patients in the control group were treated with arthroscopic treatment, and the patients in observation group were treated with arthroscopic cleaning and patellar biotherapy. The WOMAC score, the Lysholm score, and the Kujala score were compared between the two groups before and 3 months after surgery. Results There was no significant difference between the preoperative observation group and the control group (P > 0.05). The scores of WOMAC score, Lysholm score and Kujala score were higher in the observation group and the control group than those before the control group (P < 0.05 ). There were 2 cases of infection and 1 case of vascular nerve injury in 30 cases of postoperative 3 m observation group. One case of infection and 1 case of joint activity were restricted in 30 cases of control group. There was no significant difference in postoperative adverse reaction between the two groups (P > 0.05). Conclusions Given patellofemoral arthritis knee arthroplasty arthroscopy combined with patellar percutaneous nerve treatment can relieve pain, improve patellofemoral function and clinical efficacy, can be further popularized and used in clinical practice.
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Objective To investigate the clinical values of sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients.Methods From June 2012 to September 2015 in Taihe Hospital Affiliated to Hubei Medical College,136 patellofemoral arthritis knee pain patients were selected and randomly divided into treatment group (68 cases) and control group (68 cases).All patients were given arthroscopic joint clean-up surgery,the control group were given the postoperative glucosamine sulfate capsules treatment,and the treatment group were given the postoperative intra-articular injection of sodium hyaluronate choose treatment,the treatment period was 5 weeks.Results Five weeks after treatment,the response rates in the treatment group and control group were 98.5％ (67/68) and 89.7％ (61/68),and the effect of the treatment group was better(x2 =4.202,P＜0.05).The pain scores in the treatment and control group were (1.34±0.45) points and (2.89±0.62) points,significandy lower than that of before operation ((7.30 ± 0.76) points and (7.31 ± 0.56) points;t =34.855,25.142;P ＜ 0.05).The Lysholm score in the treatment and control group were (88.87 ± 6.33) points and (76.13 ± 5.98) point,significantly higher than before operation ((44.23 ± 4.29) points and (44.67 ± 5.13) point;t =14.875,8.113;P＜0.05).The incidence of adverse events during the treatment in the treatment group and the control group were 8.8％(6/68) and 13.2％(9/68) respectively,there was no significant differemce between the two groups (x2 =0.391,P＞0.05).All adverse reactions after symptomatic treatment were improved.Conclusion Sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients can effectively play the role of promoting the knee pain and function,and has good efficacy and safety,and is worth popularizing and applying.
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Patellofemoral arthritis is a fairly common disease, and it has been gaining interest with increasing number of studies due to its diverse treatment methods. Patellofemoral arthritis has a broad range of management options according to the characteristics of individual diseases. Identifying whether patellofemoral arthritis is the primary cause of knee pain and is compartment arthritis is necessary for establishing an adequate treatment method. Through investigation of the literature, the issues of recent knowledge of femoropatella arthritis and the diagnosis and treatment of which were studied.
Subject(s)
Arthritis , Knee , OsteoarthritisABSTRACT
PURPOSE: The purpose of this study were to evaluate the relationship between anterior knee pain and changes of patellofemoral joint in osteoarthritic knee. MATERIALS AND METHODS: We analyzed 200 patients who had undergone total knee arthroplasty and divided them into two groups ; the group 1(100 cases) with anterior knee pain and the group 2(100 cases) without it. We prospectively measured congruence angle and patellar height, and compared radiologic degenerative changes and operative findings(Outerbridge classification) of patella. RESULTS: The average congruence angle of patella was 11.2+/-1.6degrees in the group 1 and 2.8+/-1.3degrees in the group 2(p<0.05). Patellar height had no significant difference between two groups(p=0.62).For radiologic patellofemoral(PF) degenerative change, the group 1 showed mild degenerative change in 16 , moderate change in 47 and severe change in 37 in plain radiographs. The group 2 showed mild degenerative change in 53 and moderate change in 47 in plain radiographs(p<0.05). For cartilage degenerative change in patella(Outerbridge classification), whereas grade 3&4 were dominant in the group 1 with 71 cases, grade 1&2 were representative in the group 2 with 91 cases(p<0.05). CONCLUSION: Anterior knee pain seemed to be related with congruence angle and degenerative changes in radiologic and operative findings.
Subject(s)
Humans , Arthroplasty , Cartilage , Knee , Osteoarthritis , Patella , Patellofemoral Joint , Prospective StudiesABSTRACT
PURPOSE: To analyse clinical result of total knee arthroplasty without patellar resurfacing who had moderate to severe patellofemoral arthritis. MATERIALS AND METHODS: Unilateral knee joints of 54 cases, diagnosed to be moderate to severe patellofemoral arthritis on the basis of Ahlback's radiographic evaluation score of patella on preoperative plain radiography among the patients undergone the total knee arthroplasty due to primary degenerative osteoarthritis at this hospital between January 2000 and March 2004, were subject to this study. Patellar resurfacing was not performed in any cases. Likewise, the knee score of Hospital for Special Surgery and Feller's patellar score were used in clinical assessment preoperatively, and was used two years after the operation. RESULTS: The knee score of Hospital for Special Surgery was increased from 55.1 (35~78) to 82.8 (67~95), and also Feller's patellar score was increased from 19.1 (11~24) to 28.3 (18~30) after operation. Mild anterior knee pain was observed in 5 cases (9.3%) after the operation, but medication was needed in just 2 cases. The 42 cases (77.8%) could normally go up and down stairs without holding the rail. CONCLUSION: The total knee arthroplasty without patellar resurfacing, performed for the patients diagnosed with moderate to severe patellofemoral arthritis related with the indication for patellar resurfacing, derived satisfactory outcomes.