Arthroscopic Debridement Combined With Chinese Import Efficacy Of Ultrasound Treatment Of Knee Osteoarthritis Was Observed

Research Background:Knee osteoarthritis(Knee Osteoarthritis,KOA)is a chronicprogressivebone and joint disease, characterized by degeneration inknee joint cartilage andsurrounding softtissue and secondarybone hyperplasia,whose main clinical manifestations is pain,limited mobility. Mildsymptoms is accidentalor intermittent,activity or cold can be a predisposing factor. Severe symptoms is characterizedbypersistent pain and limited mobility, will appear limp and joint instability. The incidence of the disease is high,especially forpeopleover the age of60it isa kind of common and frequently occurring disease. Along with the increased aging of society,more and morepeople are suffering fromknee osteoarthritis. Painand disabilitycaused by knee osteoarthritis seriously influences patient’s survivaland quality of life,greatly increases the family and socialeconomic burden.Currently,for patients with more severe KOA, theeffect of conservative therapy of TCM and Westernmedicine are not good,often require surgical treatment. The aim of this study was toexplore the therapy of relieving pain,promoting the recovery ofjoint repairand function in theperioperationperiod. Methods of oral western medicine treatment of thisdisease is relatively limited, and the side effects is more, Should not beused for a long time. In contrast, the traditional Chinese medicine has moreunique characteristics and advantages, through treatment based on syndrome differentiation, and overalladjustment,internal and external, to alleviate thesymptoms, improvefunct ion. External treatment of TCMhas many advantages such as reliable curative effect, less side effect, convenient use, low cost, has been widelyrecognized bypatientsandclinicians.Clinical Research:Purpose:(1)Objectively evaluate the clinical efficacy of treating the knee osteoarthritis by arthroscopic debridement combined withtraditional Chinese medicine (Self-madeTongluozhitonggel) phonophoresis.(2)Clear the clinical characteristics and advantages of Chinese medicinephonophoresis, provide evidence-based medical basis forits clinical application. Methods:By using the method ofclinicalobservation, the subjects wereinpatients inthe Third Affiliated Hospital of Beijing University of Chinese Medicine. According to the inclusionandexclusion criteria,50cases were selected,using random number tablegroup,25cases in test group,25cases in the control group. The testgroup receivedarthroscopic debridement,perioperation and postoperationperiodwith the application oftraditional Chinese medicinephonophoresis,daily one times,each time for20minutes,the course was two weeks (continuous), After three months,we continue to the next course of treatment,four coursesin one years in general. The control group receivedarthroscopic debridementand conventional treatment. Applythe VAS painscore andLysholm score of knee joint function to compare the clinical curative effect ofanalgesiceffectbefore and after treatment.Results:Selecting cases to each group, experimental group and control group were not statistically significant(P>0.05) in the difference of gender,age, course of disease, Limbposition,X-raygrading, scores of group clinical symptoms. Before treatment, the baseline of the treatment group and thecontrol group is consistent,comparable, and reliability.(1)After treatment ofone week,one month,three months,six months,and one year,the changes of VAS score andLysholmscore in the experimental groupand the control group were significantly different from that ofprior treatment(P<0.05). Butthe two indexes were graduallystabilized,and as the disease progressed, VAS score of part patients even rebounded,the Lysholm scorehas fallen.(2)After treatment of one month,three months,six monthsand one year,the changes of VAS score andcurative effect evaluation of Lysholm score of the experimental groupwere considered to be significantly different from that of the control group(P<0.05). There is also statistical significant differences inLysholm score between two groups after treatment of one week、one month、 three months、six monthsand one year.(3)After treatment ofone week,the change of VAS score of the experimental groupwas not considered to be significantly different from that of the control group(P>0.05).(4)After treatment of one week,one month,three months,six months,and one year, the changes of curative effect evaluation of VAS score of the experimental groupwas not considered to be significantly different from that of the control group(P>0.05). But there is statistical significant differences inVAS scoreinother corresponding time except after treatment of one week(P<0.05).No adverse reactions were foundinclinicalfollow-upobservation. The safetyevaluation indexes(Laboratory)of patients were within thenormal rangebefore and aftertreatment in the experimentalgroup and the control group.Conclusion:Through the aboveanalysis we can see:(1)Thecurative effect of arthroscopic debridement on earlyknee osteoarthritisis exact.(2)In the relievingsymptoms and improving function aspect,thecurative effect ofassociationwith application of traditional Chinese medicine phonophoresis in peri operation and postoperation periodis better than the singleapplication ofarthroscopic debridement.(3)There was a correlation between effect of treatmentof the traditional Chinese medicinephonophoresistherapy and treatment time. Some patients could not tolerate the pain due to trauma in the early stage after operation.It should be used with other methods of pain relief in conjunction at our discretion.(4) We could generalize that both arthroscopic debridement and the traditional Chinese medicine phonophoresis played great role in analgesic effect, but the combination of the two is better during follow-up by comprehensively analyzing. The formercleared cumulative factors of producing pain,the latter block some pathological factorsof producing pain, the two complement each other. However, a combination of both treatments did not fundamentallyalterthe process of the pathological change of KOA. With the development of disease, symptoms were likely to worsen. But the overall effect is obvious, it has not yet reached the degree of joint replacementoperation.(5)The security of the traditional Chinese medicine phonophoresis is high,hasno obvious adverse reaction.In conclusion,we have obtained the curative effect and functioncharacteristics of treating KOA by arthroscopic debridement combined withtraditional Chinese medicine phonophoresis, achieved the purpose of the study through controlled clinical study. It provided the basis of evidence-basedfor the clinical application.