The Early And Middle Period Clinic Therapeutical Treatment Efficacy Comparation Between Extracorporeal Shock Wave Therapy And Arthroscopic Surgery On The Treat-ment Of Knee Osteo Arthritis In Middle-late Stages

Objective: By comparing the early-middle treatment efficacy of middle-late knee osteoarthritis between arthroscopic surgery with Extracorporeal Shock Wave Therapy Explore their advantages of the two methods of treatment treatment of knee osteoarthritis.Methods:76 cases(87knees)of knee osteoarthritis(Kellgren-LawrenceII、III、IV stage)were divided into extracorporeal shock wave therapy group and arthroscopic surgery group.ESWT group adopt to shock wave treatment,suffering from knee pain points 1 time/week,a total of 5 times,each time after the ESWT treatment inject 2ml sodium hyaluronate into the knee.Arthroscopic surgery group using arthroscopy cleaning surgical treatment,postoperative inject sodium hyaluronate 2 ml into the knee,1 times a week last 1 month,a total of 5 times,2、4,12,24 weeks after treatment were followed,Every time follow-up record Lysholm functional score.In 12,24 weeks take out joint fluid more than 0.5ml to detection the content of MDA and SOD in joint fluid.Results:(1)the arthroscopy group: phase II stage KOA at,2,4,12,24 weeks after arthroscopic treatment of Lysholm function score and VAS scores were better than before treatment(P < 0.05);Phase III,IV stage,12 weeks of Lysholm function score and VAS score is better than that of before treatment(P < 0.05).(2)ESWT group II and III stage KOA after ESWT treatment VAS score and the Lysholm functions are better than that of before treatment(P <0.05)in each follow time,IV stage 2,4,12 weeks of VAS score and the Lysholm functional score is better than that of before treatment(P <0.05).(3)compared between groups: II stage of KOA arthroscopy and ESWT in VAS score and the Lysholm functional score comparison in each fellow time,there was no statistically significant difference(P > 0.05);III KOA stage in VAS score and the Lysholm function score,ESWT group is better than that of arthroscopy group(P < 0.05)in each fellow time;IV KOA stage at 4,12 weeks VAS score and Lysholm function score comparison,ESWT is better than that of arthroscopy group(P < 0.05).(4)the curative effect comparison:phase II knee osteoarthritis,there was no statistically significant between ESWT group and arthroscopy group(P > 0.05);III and IV KOA stage,ESWT is better than that of arthroscopy group(P < 0.05).(5)Patients with stage III or IV knee osteoarthritis,ESWT for improving the effect of joint fluid SOD content and decrease MDA content is better than that of arthroscopic surgery.Conclusion(s):The curative effect of ESWT and arthroscopic treatment for the treatment of stage II knee osteoarthritis is similar.The curative effect is better than stage III or IV KOA both in ESWT and arthroscopic groups,early intervention for osteoarthritis can obtain good effect.The curative effect of ESWT is better than arthroscopic surgery at stage III or IV KOA ESWT can be adopt as a a conservative treatment method of late KOA.For patients with stage III or IV KOA extracorporeal shock wave to reduce the ability of oxygen free radicals in the joint fluid is better than that of arthroscopic surgery,this could be one of the mechanism of its function.