The Comprehensive Measures About The Joint-Debridement Through Arthroscopy To For Gouty Arthritis

OBJECTIVE:To study the methods and the effect of the therapy of the Gouty joint synovitis and joint calculi through arthroscopy.METHODS:The clinical data of38patients(45knees) of Gouty arthritis who were made a diagnosis and give treatment in our hospital from March2012to October2013were retrospectively analyzed. The age of the patients ranges from32to61,with a average age of45.Among them,12have lesions existing in the left knee and19are right one and7have lesions in both knees.8are first flare and30are relapse. The course of the disease ranges from2months to20years,with a frequency of once to three times a year and the duration are1to2weeks.The knee joint can stretch (5.76±3.71)°and flex (85.37±8.42) and have a motion of knee joint (80.10±8.48)°and the Lysholm mark is (62.3±6.2) before surgery.34of the patients had a hyperuricemi.20of the cases receive a therapy of arthroscopy removal of tophus and18patinets receive a therapy of arthroscopy removal of tophus in addition of a continuously flushing drainage.All the38patients received a therapy of continuously regular management of hyperuricemia including pharmacologic treatment and nonpharmacologic treatments (such as balance diet) after the surgical treatment.The effect can be evaluated through the comparison of before and after surgery of38patients in terms of stretching and flexion and the motion of knee joint and lysholm mark.RESULT:Among the38patients(45knees),20cases (24knee) receive a therapy of arthroscopy removal of tophus and18patinets (21knee) receive a therapy of arthroscopy removal of tophus in addition of a continuously flushing drainage. After the surgical treatment,all the38patients acquired A level of healing and without complication of infection or nerve and blood vessels damage.All the38patients have received a follow-up,the course range from6months to22months and the average are9.8months.The Lysholm mark is (90.1±5.9) after6months of the surgery. The knee joint can stretch (1.43±1.83)°and flex (126.76±17.29)°and have a mobility of (125.00±17.29)°and have a Significant improvements than before surgery (p<0.05).During the follow-up,7cases suffered from recurrence and the total rate of relapse is18.4%(7/38).However,they all had a release in frequence of flare and the duration and the degree of Joint swelling and pain through the treatment.All the7recurrence are related to unregular diet-control and the bad management of hyperuricemia through inquiry.CONCLUSIONS:It’s a therapy with high efficiency and minimally invasive and remarkable effect to treat knee gouty arthritis through arthroscopy. Cooperating with regular nonpharmacologic treatments(such as balance diet) and pharmacologic treatment,the therapy though arthroscopy can validly treat knee gouty arthritis.