| Objectives Arthroscopy has been used in the first surgical treatment of patella fractures.However,at present,no fracture has reached clinical healing.When the internal fixation is removed again,the specific damage and recovery of the patella cartilage surface are visual to evaluated and analyzed under the arthroscopy.There is also no specific operation method,literature report,and summary of the operation timing of removing the secondary internal fixation to timely perform cartilage repair to prevent the effect of cartilage further destruction on joint function.This study analyzed the first surgical treatment of arthroscopy of patella fractures,and wash out arthroscopy when the internal fixation was removed after fracture healed completely.the second application of the arthroscopy technique,the dynamic and phased evaluation,analysis and timely treatment of the osteochondral injury of the patella,repair,and healing are carried out under arthroscopy visualization.The value of the second application of the arthroscopy technique of the repair and treatment of the patellar fracture of the knee joint and patella osteochondral injury was discussed to better improve the clinical surgical treatment effect.Methods from February 2015 to June 2018 in our hospital,68 patients with fractures of the patella with cartilage injuries were selected,and 4 typical cases were selected.The patella fractures were treated with arthroscopic assistance,and the fractures of the patella were examined,washout,repaired and evaluated after arthroscopic fracture healing(mean 9 months).There were 2 males and 2 females,1 car accident,2 falls,1 fall from height;3 left knees and 1 right knee;2 cases was Rockwood type ?,1 case IV type,and was V type 1 Case,the mean age was 41.75±8.34 years.According to the patient's postoperative pain,knee range of motion,knee stability,and other follow-up information analysis.Pain sensation scores were performed at 1,3,and 5 days after surgery using VAS scores;knee function scores were performed at 2,3,6,and 9 months after HSS score.The classification of cartilage injiuy under Outbridge arthroscopy was used to analyze the healing of patella cartilage post operation.The healing of patella-femoral cartilage was analyzed by using Jackson&baue's arthroscopic classification of cartilage damage.Result1.The postoperative VAS score of the patients in this group was 7.25±0.96 on the first day,4.00±0.82 on the third day and 1.50±0.58 on the fifth day.The pain index was measured three times and was decreased.2.The postoperative HSS knee function score of this group was 64.25±4.86 at 2 weeks,75.00±4.08 at 3 months,86.25±3.86 at 6 months,and 95.50±2.08 at 9 months.The postoperative knee score showed an increasing trend with time.3.The postoperative Lysholm knee score in this group was 66.00±4.08 at 2 weeks,75.75±2.87 at 3 months,84.25±2.87 at 6 months and 96.50±1.29 at 9 months.The postoperative knee score tended to increase with time.4.Kellgren-Lawrence(K-L)grading criteria after bony healing of patella fracture were normal in 2 cases and grade I in 2 cases.5.The classification of the cartilage damage in the knee arthroscopy after the bony healing of patella fracture was normal in 2 cases and grade I in 2 cases.6.Jackson&baue cartilage injury grade in knee arthroscopy after bony healing of patella fracture was normal in 3 cases and grade I in 1 case.Conclusion After the bony healing of patella fracture,the arthroscopic treatment can be used to determine the damage,repair,and healing of patella osteochondral bone by arthroscopy,to make a comprehensive evaluation.According to the new lesions found under the arthroscopic,it is necessary to timely perform the arthroscopic debridement and washing-out to slow down the progression of articular cartilage degeneration;Arthroscopic treatment of soft tissue of patella can assist patella under direct vision.The repair of patella cartilage is more direct and definite.It can also make a diagnosis,treatment,and evaluation of other lesions in the knee joint in a timely.The secondary application of arthroscopy in the treatment of patella osteochondral injuries needs further research and promotion. |
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