Observation On The Clinical Efficacy Of Ultrasound Guided Needle Knife In The Treatment Of Knee Osteoarthritis

Objective:1.Observe the short-term clinical efficacy of ultrasound guided needle knife therapy through the clinical trail.Compare the clinical efficacy of ultrasound guided needle knife therapy and traditional needle knife therapy through patients' symptoms and signs.2.Observe the differences of pain on the knee(VAS)and function of the knee score(Lysholm score)on patients by two different treatments.3.Observe the adveres reaction of ultrasound guided needle knife therapy and traditional needle knife therapy.4.Explore the advantage and efficacy of ultrasound guided needle knife therapy,and forecast the feasibility and necessity of it.Methods:Patients of KOA are recruited from Outpatient Department and Inpatient department of Recovery Unit in the hospital,from January 2016 to December 2016,and 60 cases of eligible paients are recruited in the end.They will get the number based on the time when they are recruited,and then they will be divided into two groups randomly,which named A group and B group,each group of 30 cases.A group:ultrasound guided needle knife therapy,B group:traditional needle knife therapy,and all patients agreed to treat and signed informed consent.One week for a treatment course and they will treat once a week.A total of three courses of treatment.Before the treatment,all patients will finish routine blood test and blood clotting test,and so on.Before,in(after 1 week treat 2 times)and after(after 1 week treat 3 times)the treatment,they will finnish the evaluation scales,and adverse reactions should be recorded during treatment.Through studies,observe the short-term clinical efficacy and safety of ultrasound guided needle knife therapy.And explore the advantage of ultrasound guided needle knife therapy comparing with traditional needle knife therapy.The results:1.Comparison of the pain on the knee(VAS): Compare with the score before treatment,in and after treatment of each group,they were all relieved after the treatment,and the differences make sense according to the statistics(P<0.01),which means two meathods have effect on reliefinng the pain.It makes a difference between A group and B group in treatment(P<0.01),after reatment(P<0.05),which means A groups are better than B groupson reliefinng the pain,especially in treatment.2.Comparison of the function of the knee joint score:These treatments all do good to the function of the knee,for instance,they can relieve knee pain,reduce swelling of the knee and ameliorate mobility of knee join.It makes a difference between A group and B group in the aspect of knee pain,a sense of lockout,swelling of the knee,ameliorate mobility of knee join,and the diference is significant(P<0.05).Meanwhile,the score of the rest was no significant difference(P>0.05).2.Clinical efficacy of treatments about KOA patients:The clinical efficacy was calculated by comparing the Hss knee osteoarthritis score before,in and after treatment to form the rate of improvement.In the treatment,A group removed off 1 cases,5 patients were recovery,12 patients were markedly effective,6 patients were effective,and the total efficiency is about 93.10%.B group removed off 2 cases,2 case was recovery,6 cases were markedly effective,15 cases were effective,5 ceses were ineffective,and the total efficiency is about 82.14%.Comparison of clinical efficacy in the treatment:A group is better than B group(P<0.01).After the treatment,A group removed off 2 cases,8 patients were recovery,14 patients were markedly effective,5 patients were effective,and the total efficiency is about 96.42%.B group removed off 3 cases,4 casewas recovery,10 cases were markedly effective,10 cases were effective,3 ceses were ineffective,and the total efficiency is about 88.89%.Comparison of clinical efficacy after the treatment:A group is better than B group(P<0.05).3.Adverse reaction:During the period of the treatment,adverse reactions occurred in 1 case of A groups,which were charactered by blooding and pain,and adverse reaction rate is about 3.57%.While 3 case of B groups were charactered by pain,blooding,blood stasis,and the rate was about 11.11%.But the symptoms of joint swelling,dizziness,accelerating heart rate and needle eye infection and other adverse reaction hadn't happened.Comparison of the adverse reaction of them,the differences were not statistically significant(P>0.05),that means two mathods are safty and reliable.Conclusion:1.Traditional needle knife therapy have better effect on short-term clinical efficacy than traditional needle knife therapy,and is safe and credible.2.Campared with the function of relieving the knee pain and ameliorating a sense of lockout of the knee joint,ultrasound guided needle knife therapy is better than traditional needle knife therapy.Ultrasound guided needle knife treatment effect faster than traditional needle knife on efficacy.2.Throught its visualization of the angle,ultrasound guided needle knife therapy will make it more accurate to find the tissue where we need to operate than traditional needle knife therapy positioning by five fingers.Further more,ultrasound can show vessels and nerves.Although the adverse reaction is insigficant,we can predicit that it can reduce the chance of damage on vessel and nerve camparing with traditional needle knife therapy based on plenty of samples.