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| Effect of ultrasound-guided acupotomy of popliteal oblique ligament combined with intra-articular injection of Sodium Hyaluronate in the treatment of knee osteoarthritis with flexion deformity |
| YUAN Ding1 SHAN Fenfen2 LI Tao3 ZHANG Jian1 SHI Rongrong1 JIANG Ping1 WANG Chun4 WANG Weijun1 BI Yanzhen5 |
1.Department of Emergency, Qingdao Municipal Hospital, Shandong Province, Qingdao 266000, China;
2.Department of Pathology, Qingdao Municipal Hospital, Shandong Province, Qingdao 266000, China;
3.Department of Joint Surgery, the Affiliated Hospital of Qingdao University, Shandong Province, Qingdao 266000, China;
4.Department of Ultrasound, Qingdao Municipal Hospital, Shandong Province, Qingdao 266000, China;
5.Department of Infectious Diseases, Qingdao Municipal Hospital, Shandong Province, Qingdao 266000, China |
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Abstract Objective To investigate the clinical efficacy of ultrasound-guided acupotomy of popliteal oblique ligament combined with intra-articular injection of sodium hyaluronate in the treatment of knee osteoarthritis with flexion deformity. Methods A total of 108 patients diagnosed of knee osteoarthritis with flexion deformity in Qingdao Municipal Hospital from January 2021 to December 2021 were selected, and they were divided into treatment group and control group according to the random number table method, with 54 cases in each group. The control group was treated with intra-articular injection of Sodium Hyaluronate, and the treatment group was treated with ultrasound-guided acupotomy of popliteal oblique ligament basis on the control group, once a week, five consecutive times. The Hospital for Special Surgery (HSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS) scores before and after treatment were compared, the clinical efficacy and complications were compared between the two groups. Results After treatment, the HSS score of the treatment group was higher than that before treatment, and the HSS score of the treatment group was higher than that of the control group, the differences were statistically significant (P＜0.05). The pain, stiffness, functional scores and total scores of WOMAC in both groups were lower than before treatment, and the treatment group was lower than the control group, the differences were statistically significant (P＜0.05). After treatment, VAS score of the treatment group was lower than that before treatment, and VAS score of the treatment group was lower than that of the control group, the differences were statistically significant (P＜0.05). The clinical effect of the treatment group was better than that of the control group, and the difference was statistically significant (P＜0.05). There were no complications such as infection, hematoma and allergic reaction in the two groups. Conclusion Ultrasound-guided needle knife release of the oblique popliteal ligament combined with intra-articular injection of sodium hyaluronate can significantly relieve knee pain and improve knee flexion deformity. The therapeutic effect is better than that of intra-articular injection of Sodium Hyaluronate alone, and have high safety.
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[1] 尹正录，孟兆祥，王继兵，等.关节内注射富血小板血浆或玻璃酸钠联合等速肌力训练对膝骨性关节炎的影响[J].中华物理医学与康复杂志，2019，41（10）：764-768.
[2] 刘娜，孙银娣，姜小凡，等.股内收肌群激痛点小针刀治疗膝骨关节炎的临床效果[J].中国医药导报，2022，19（27）：132-136.
[3] 吴思，邓书童，张红安.膝骨性关节炎红外热像表现及膝关节痛点分布规律分析[J].中国中医骨伤科杂志，2017， 25（1）：30-33.
[4] 周友龙，胡闯北，张雅琪，等.膝骨关节炎中西医治疗进展[J].辽宁中医药大学学报，2019，21（1）：11-15.
[5] 方丽娜，李上封，袁红丽，等.“膝六”“膝七”点针刀松解对早中期膝骨关节炎的疗效研究[J].中国医药导报，2022， 19（18）：27-32.
[6] 胡国强，李德龙，刘际石.肌骨超声引导下针刀与常规针刀治疗膝骨关节炎的效果比较[J].中国医药导报，2022， 19（27）：145-148.
[7] 中华医学会骨科学分会.骨关节炎诊治指南（2007年版）[J].中华骨科杂志，2007，27（10）：793-796.
[8] Huskisson EC. Measurement of pain[J]. Lancet，1974，2（7889）：1127-1131.
[9] Insall N，Dorr D，Scott D，et al. Rationale ofthe knee society clinical rating system [J]. Clin Orthop Relat Res，1989，248（23）：13-14.
[10] 胡国强，薛宝山，刘际石，等.基于人体弓弦力学理论探讨针刀治疗膝骨关节炎的临床效果[J].中国医药导报，2021，18（18）：172-175.
[11] 郑筱萸.中药新药临床研究指导原则（试行）[M].北京：中国医药科技出版社，2002：349.
[12] 毛宾尧，盖维缤，牛家度，等.腘斜韧带损伤[J].滨州医学院学报，1984（1）：32-33.
[13] 宋萍，王小荣，黎一页，等.玻璃酸钠联合复方倍他米松对比玻璃酸钠治疗膝关节骨性关节炎疗效的Meta分析[J].中国药房，2019，45 （16）：198-200.
[14] 卢胜春，陈春花.针刀医学病因病理探讨[C]//中华中医药学会针刀医学分会.中华中医药学会针刀医学分会2013年度学术年会论文集，2013：36-39.
[15] 张希，刘萍.骨性关节炎所致慢性持续性疼痛的发病机制[J].中国骨质疏松杂志，2017，23（2）：248-255.
[16] 洪汉青，张彩荣，陈德春，等.针刀治疗膝骨性关节炎的临床效果[J].中国医药导报，2019，16（9）：162-165，169.
[17] 刘圣星，王隆辉，韩贵宾.依托考昔片联合玻璃酸钠注射液治疗膝关节骨性关节炎的临床研究[J].中国临床药理学杂志，2019，35（3）：45-47.
[18] 刘晶，赵红佳，林巧璇，等.超声可视化经筋弓弦针刀松解术治疗膝骨关节炎的效果[J].中国医药导报，2022， 19（9）：153-156，172.
[19] 王信亭，胡月，曾立志，等.超声引导下针刀联合药物注射治疗膝骨关节炎[J].中国临床研究，2022，35（6）：805- 809.
[20] 栗晓东，刘红军，迟文，等.基于人体弓弦力学理论探讨针刀治疗膝骨关节炎的临床效果[J].中国医药科学，2023，13（19）：99-102.
[21] 张美娟.膝关节生理解剖环境对膝关节生物力学特性的影响[J].中国组织工程研究，2012，16（26）：4903-4907.
[22] 申毅锋，周俏吟，李石良.超声引导下针刀治疗研究进展[J].中国医药导报，2017，14（33）：55-58.
[23] Jungmann PM. Posteromedial corner of the knee [J]. Der Radiologe，2019，59（2）：155-168.
[24] Hedderwick Mandy. The oblique popliteal ligament：an anat- omic and MRI investigation [J]. Surg Radiol Anat，2017，39（9）：1017-1027.
[25] Wu XD，Yu JH，Zou T，et al. Corrigendum：Anatomical Characteristics and Biomechanical Properties of the Oblique Popliteal Ligament [J]. Sci Rep，2017，7（1）：46117.
[26] Science. Anatomical Characteristics and Biomechanical Pro- perties of the Oblique Popliteal Ligament [J]. Sci Lett，2017， 24（4）：799-802.
[27] Wu XD，Yu JH，Zou T，et al. Anatomical Characteristics and Biomechanical Properties of the Oblique Popliteal Ligament [J]. Sci Rep，2017，7（1）：42698.
[28] Chuan-chen Kao，高传真，Tsung-kuei Kao，等.针刀医学临床评估标准—以膝关节骨性关节炎的量表测评为例[C]//中华中医药学会针刀医学分会2017年.香港中医学会、教育研究基金会，2017.
[29] Davies AP，Rating systems for total kneereplacement [J].Knee，2002，9（4）：261-266.
[30] 陈蔚，郭燕梅，李晓英，等.西安大略和麦克马斯特大学骨关节炎指数的重测信度[J].中国康复理论与实践，2010，16（1）：23-24.
[31] 王信亭.超声引导下针刀联合膝关节药物注射治疗膝关节骨性关节炎的临床疗效观察[D].青岛：青岛大学，2022.
[32] 吕良友.玻璃酸钠配合针刀松解治疗膝关节骨性关节炎30例[J].中医外治杂志，2022，31（4）：18-20. |
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