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Efficacy of Arthroscopic Peripatellar Release Combined with Peripatellar Denervation in the Treatment of Anterior Knee Pain in Patellofemoral Arthritis and Its Effect on the Degree of Cartilage Degeneration |
WU Peng, JI Zhenwei, FENG Chongyang, et al |
The Second Affiliated Hospital of Air Force Military Medical University of Chinese People's Liberation Army, Shaanxi Xi'an 710038, China |
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Abstract Objective: To study the efficacy of arthroscopic peripatellar release combined with peripatellar denervation in the treatment of patellofemoral arthritis (PFOA) with anterior knee pain and its effect on the degree of cartilage degeneration. Methods: A total of 155 patients with PFOA and anterior knee pain were divided into study group (78 cases) and control group (77 cases) by the simple random grouping method. Both groups were treated with arthroscopic debridement, the control group with denervation and the study group with peripatellar release combined with peripatellar denervation, and they were followed up for 6 months after surgery. The efficacy, cartilage degeneration degree, knee function and adverse reactions of the two groups were recorded and compared. Results: Postoperatively, VAS scores were lower in both groups at all times compared to preoperatively, with time, group and interaction effects, and the study group was better than the control group (P<0.05); postoperatively, Lysholm knee function (LKSS) scores improved and the scores of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were significantly lower in both groups compared to preoperatively (P<0.05), and the study group was significantly better than the control group (P<0.05), and the differences of the above scores before and after surgery in study group were higher than those in control group (P<0.05). After treatment, the expression of matrix metalloproteinase-3 (MMP-3) was significantly decreased while the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) was significantly increased, and the expressions were significantly better in study group than those in control group, and the differences of the above indicators before and after surgery were higher in study group compared with those in control group (P<0.05). The number of postoperative complications in the study group was slightly lower than that in the control group, with incidence rates of 8.97% and 12.98% respectively, with no significant difference (P>0.05). Conclusion: Arthroscopic peripatellar release combined with peripatellar denervation in patients with PFOA and anterior knee pain can prompt the early recovery of knee motor function, reduce pain and slow down the degree of cartilage degeneration, with clinical promotion value.
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