Therapeutic Effect Of Different Methods On Moderate Knee Osteoarthritis Complicated With Severe Pain

Objective: Knee osteoarthritis follows the concept of a stepwise treatment.There is no fixed treatment for moderate knee osteoarthritis complicated with severe pain.The 50-60 age group is the transition period for treatment options.Conservative treatment,knee arthroscopic treatment and knee replacement treatment are suitable for such patients.This study analyzed the clinical outcomes of different treatments for moderate knee osteoarthritis in the 50-60 age group with severe pain.Seeking more effective and reasonable treatment options.Methods: Patients with knee osteoarthritis from First Affiliated Hospital of China Medical University were enrolled.Patient's age is between 50 and 60,the X-ray plain film K/L was moderate(II-III grade),and the preoperative WOMAC pain assessment(using VAS scale scores)scored at least 35 points.The patients were divided into three groups,including conservative drug therapy(group A),knee arthroscopic treatment(group B),and total knee arthroplasty(group C).The corresponding treatment plans were appled to each group and the patients were instructed to perform functional exercise.The WOMAC pain assessment scores of each group were recorded at 1 week before surgery,1-3 months after operation,and 12-16 months after operation.Excluding patients who were lost to follow-up,110 patients were finally followed up.30 patients in group A(3males,27 females),43 patients in group B(14 males,29 females),and 37 patients in group C(7 males and 30 females).The WOMAC pain assessment scores were statistically analyzed using statistical software SPSS 23.0 to compare the efficacy of different treatment regimens.Among them,aduring 1-3 months after operation,some patients in group B were lack of rehabilitation and exercise awareness,and the early pain index was high.Group B was divided into patients group with poor adherence(group B1)and patients group with good adherence(group B2).Rehabilitation education and supervision were carried out for group B1,and rehabilitation training awareness was strengthened.Group B2 continued to perform functional exercise.The WOMAC pain assessment scores of 12-16 months after surgery were collected,using SPSS23.0Statistical analysis was performed to evaluate the effect of rehabilitation exercise.Results: There was no significant difference in pain index scores among group A,B and C during 1 week before operation(P>0.05).Knee arthroscopy(group B)was better than total knee arthroplasty(group C)than conservative treatment(group A)during 1-3months after operation(P<0.05).Total knee arthroplasty(group C)was better than knee arthroscopy(group B)than conservative treatment(group A)during 12-16 months after operation(P<0.05).There were significant differences in pain index scores between the group B1 and group B2 during 12-16 months after operation(P<0.05).In the group B1,the pain index scores of 12-16 months after surgery were lower than those of 1-3 months after surgery.And the pain index scores of 12-16 months after surgery were similar between the group B1 and group B2.It shows that postoperative rehabilitation and functional exercise can improve the symptoms of patients.Conclusions:For patients with moderate knee osteoarthritis with severe pain.The efficacy of conservative treatment is not as good as surgery.The early effects of knee arthroscopy are significant.However,at 12-16 months of follow-up,total knee arthroplasty was superior to knee arthroscopy.Postoperative rehabilitation and functional exercise play a very important role in improving the symptoms of patients.