A Study On The Effect Of Arthroscopic Release Of Medial Collateral Ligament In The Treatment Of Middle Stage Knee Osteoarthritis

Objective:Arthroscopic debridement is a traditional and effective method for the treatment of knee osteoarthritis.However,due to the degeneration of the medial cartilage of the knee joint,the contracture of the medial collateral ligament,and the abnormal narrowing of the medial space in some patients,the operation space of the medial posterior side of the knee joint under the microscope is still limited even after the eversion stress of the knee joint is given during the operation.The narrow surgical field of vision can prolong the operation time,increase the difficulty of operation,increase the risk of iatrogenic injury,and the effect of operation is not satisfactory.The release technique of medial collateral ligament is a simple,effective and safe method.By releasing some fibers of medial collateral ligament,the vision of medial compartment of knee joint can be effectively expanded.It has been reported that the release of medial collateral ligament can not only improve the visual field of medialcompartment of knee joint,but also relieve the pressure of medial compartment,which may correct the stress direction of lower limbs to a certain extent,so as to improve the symptoms of knee joint.Therefore,the purpose of this study is to study the effect of arthroscopic release of medial collateral ligament on knee osteoarthritis.Methods:From November 2018 to December 2019,a total of 60 patients with stage II-III knee osteoarthritis hospitalized in Dalian Central Hospital were collected and randomly divided into study group and control group,30 cases each.The study group was treated by arthroscopic debridement combined with medial collateral ligament release.After the release,the stress test of genu eversion was carried out to prevent excessive release,resulting in instability of genu joint;the control group was only given joint clearance.Both groups received the same rehabilitation training.The visual analog scale(VAS),femur tibia angle(FTA),Kellgren laerence(K-L),osteoarthritis index(WOMAC)of Western Ontario and Mc Master University were measured and recorded.General data of patients were collected at admission,including:gender,age,body mass index(BMI),occupational nature,course of disease,injury site,etc.Through statistical analysis,the curative effect of the two groups was compared,and the relationship between some general data and knee joint function was analyzed.Results: 1.VAS score and WOMAC score of the study group at 1,3 and 6 months after operation were lower than those of the control group;VAS score and WOMAC score of the two groups at 1,3 and 6 months after operation were lower than those before operation;2.VAS score of the two groups at 3 months after operation were higher than that at 1 month.The WOMAC scores of the two groups were lower than that of the first month.3.There was no significant difference between the study group and the control group in 1,3 and 6 months after operation,and between the two groups in 1,3 and 6 months after operation and before operation.4.There was no significant difference in the K-L grading between the two groups.5.The BMI,age and occupation of the patients were positively proportional to the preoperative VAS score and WOMAC score.Conclusions: 1.For the treatment of knee osteoarthritis in the middle stage,joint debridement combined with medial collateral ligament release is better than joint debridement alone.2.The release of medial collateral ligament does not change the limb alignment.3.Old age,obesity and heavy physical labor are related to the deterioration of knee joint function in patients with knee osteoarthritis.