Tcm Syndrome Differentiation Clinical Research, Combined With Osteochondral Transplantation In The Treatment Of Osteoarthritis Of The Knee

Knee Osteoarthritis (KOA) is the disorder characterized by osteophyte formation which results from articular cartilage degradation and imbalance of subchondral bone remodeling.KOA is the main negative factor affecting labor and life quality of mid-aged and aged people.Cartilage defect exists in 57.6% KOA patients.Repair of the cartilage defect and inhibition of cartilage degradation is most important for these patients.This study includes the review and the clinical research.Through reviewing the document, this study introduces the cause, auto-response, repair therapeutics of the articular cartilage.Clinical ResearchObjective To observe the clinical effect of Chinese herbs combined with autologous osteochondral transplantation to deal with cartilage defects in osteoarthritis.Methods Thirty cases of osteoarthritis patients with chondral defects of the weight-bearing surfaces were randomly devided into two growps: the experiment group and the control group. All patients were treated by the autologous osteochondral transplantation under arthroscope or openly. The experiment group were given Chinese herbs orally after operation and the control group were not given Chinese herbs. The treatment effect was evaluated by the revised Lysholm scoring scale, PG of Synovial fluid, knee MR regularly.Results The follow-up for 12-41 months after operation revealed that the treated knee joint get obviously functional improvement and pain alleviation. Knee HSS: the postoperative score were 72～100(92.5±7.1) while the preoperative score were15～63(39.7±4. 6) in the experiment group. the postoperative score were 57～89(84.5±5.1) while the preoperative score were44～68(49.3±4.8) in the control group.There were significant differences between postoperation and preoperation in both the experiment group and the control group (P<0.05). But there were not significant differences in postoperative score between the experiment group and the control group (P>0.05).PG: the postoperative PG were 80.4～493.2(263.5±141.2)μg/L while the preoperative PG were215.5～897.3(508.8±203.6)μg/L in the experiment group. the postoperative PG were 120.9～700.2(453.5±137.2)μg/L while the preoperative PG were275.7～873.3(555.8±197.3)μg/L in the control group.There were significant differences between postoperation and preoperation in both the experiment group and the control group (P<0.05). And there were also significant differences in postoperative PG between the experiment group and the control group (P<0.05) knee magnetic resonance imaging (MRI):Postoperative MRI show all the grafts were in good position and articular surface became smooth. There were significant differences between postoperation and preoperation in both the experiment group and the control group (P<0.05). But there were not significant differences in postoperative MRI scale between the experiment group and the control group (P>0.05).Chinese medicine syndrome scale: the postoperative score were 3～13(4.0±1.2)while the preoperative score were13～27(10.0±2.6)in the experiment group. the postoperative score were 5～26(13.0±3.4) while the preoperative score were2～31(12.0±3.9)in the control group.There were significant differences between postoperation and preoperation in both the experiment group and the control group (P<0.05). And there were also significant differences in postoperative score between the experiment group and the control group (P<0.05)Conclusion Autologous osteochondral transplantation is a good curative method for the cartilage defects in osteoarthritis, combined with Chinese herbs can obviously improve Chinese medicine syndrome score and synovial PG, may have a better long effect in dealing with KOA.