Clinic Study On Postmedial Approach For Knee Osteoarthritis By Using Small Needle Knife

Knee osteoarthritis Knee osteoarthritis is one of the most familiar orthopaedics diseases especially in the olds.With the development of aging society,incidence of knee osteoarthritis has been increased rapidly,which seriously jeopardize their health.In 1995,a new definition was released in the international meeting for OA,that is,OA is the result of disequilibrium of decompose and anabolic metabolism among cartilage cell,ECM and cartilage sending down fishbone,caused by the integration of mechanical and biological factors.The IL-1,6,TNF-a, NO which found in the molecule biology area are the most important factors for the cartilage damnification.In the Biology mechanics fields,the increase of the bone's inside pressure is thought as an important reason for arthrosis.In the Chinese medicine,this disease is categorized to the rheumatism caused by wind,cold,damp,etc.Knee is the mansion of tendon,and the blood stored in the liver is used to nourish tendon,and the marrow stored in the kidney is used to cultivate bone.So the weakness of liver and kidney is the essential reason,combined with the external evil of wind,cold and damp,which block the blood circulation in knee and obstruct the meridians,resulting in pains.This disease belongs to "pain in bones",and it was said in Plain Questions,"pain is the result of combination of wind, cold and damp." As there is no specific therapy to reverse the process of articular cartilage damage and hyperosteogeny,the aim of treating this disease is to easing pain,abating syndrome,postponing and even preventing the development to protect arthrosis function and prevent deformity.The disease is characterized as knee ache,weakness and ascending difficulty,attend by knee ankylosis and malformation.When there is acute synovitis,knee can be red,swell,heat and pain.It is considered that knee osteoarthritis is the unbalance of anabolism and catabolism among cartilage cell,cartilage matrix and subcartilaginous bone.ObjectiveThe research is proposed to analyze and summarize the clinical data and follow-up results in the treatment of knee osteoarthritis with small needle knife through Postmedial approach,evaluate the clinical effects of the knee osteoarthritis with small needle knife through Postmedial approach,so as to provide more satisfactory therapeutic programs for patients.MethodsFrom October in 2006 to October in 2007,204 cases in our department were randomly divided into two groups equally,including the observed group with small needle knife through postmedial approach and the control group through anterior approach according to the standard of osteoarthritis of American Rheumatism Association.Patients were treated once every week during 4 weeks and evaluated before and after treating.Results(1)Comparison of therapeutic effects after treatment between two groups shows that,the general effective rate is 98.06%in observed group and 84.74%in control group,between which was significant difference(P<0.05).(2)Self-compare of the marks of pain,joint ankylosis,function,tenderness,swell,joint mobility all decrease siginificantly,and it is also found that observed group was superior to that of control group,which were significantly different with t test(P<0.05).(3)The followed-up periods ranged 6 months for patients whose therapeatic effects are superior,and the recurrent rate in the observed group was is lower than of the control group,which were significantly different with t test(P<0.05).ConclusionThe result shows that the observed group has obvious therapeutic effect than control group,and the patients are more satisfied in the observed group,which also point out that the apperance of the trigger points in post side of the knee is more bigger than the anterior side. The treatment of small needle knife through Post- medial approach has obvious therapeutic effect on knee osteoarthdtis,which is better than anterior approach.Based on the reseach,it is considered that therapeutic effect with small needle knife through Postmedial approach is superior to anterior approach,which is worthy to be studied deeply.