| Objective:To investigate the clinical efficacy of the combined traditional Chinese and Western medicine therapy of debridement and reshape of cartilage postoperative guided training programs on recovery of knee joint function and repair of cartilage injury in patients with acute chondral injury of patellar joint.Methods:Methods:In the randomized controlled clinical observation study,a total of 60 eligible patients with acute chondral injury of patellar joint undergoing debridement and reshape of cartilage in our department from March 2019 to December 2020 were retrospectively analyzed.They were randomly divided to treatment group(n=30)and control group(n=30)using the random number method.Patients in control group were treated with debridement and reshape of cartilage,health education after knee arthroscopy,whilst those in treatment group were given to traditional Chinese manipulation and guided training program and range of motion(ROM)of knee joint with three times daily.Guided training programs in treatment group were strengthened based on the recovery situation of the injured leg,for consecutive 8 weeks.At the same time,deep squat should be avoided within 8 weeks after operation.Visual analogue scale(VAS),Lysholm knee score and ROM of affected knee joint were recorded before surgery,and 4th and 8th week after surgery.Based on Lysholm scores and clinical symptoms of patients at the 4th and 8th week after surgery,the function of affected knee joint was graded into good,fair and poor.The rates of good and fair knee joint were calculated.Moreover,MRI examination of knee joint was performed at the 8th week after surgery,which was used to compare with preoperative MRI findings,so that the effectiveness of the clinical efficacy of the combined traditional Chinese and Western medicine therapy of debridement and reshape of cartilage+ postoperative guided training programs on repair of cartilage injury was assessed according to the International Cartilage Repair Society(ICRS)Classification.Results:A total of 51 patients with acute chondral injury of patellar joint belonging to the syndrome of Qi and blood obstruction were finally recruited,including 25 in control group and 26 in treatment group.In control group,there were 16 females and 9 males,with an average age of 34±7 years.17 females and 9 males were included in treatment group,with an average age of 35±8 years.There were no significant differences in age,sex,VAS scores,Lysholm scores and ROM of affected knee joint between groups(P>0.05),indicating that their baseline characteristics were comparable.VAS scores:VAS scores at the 4th and 8th week postoperatively were obviously reduced than those recorded before surgery in both groups.Besides,VAS scores at the 4th and 8th week postoperatively in either control group or treatment group were significantly lower than baseline(P<0.05).However,there was no significant difference in VAS scores at the 8th week postoperatively between groups,whilst that at the 4th week was statistically significant as more superb in treatment group.ROM of affected knee joint:ROM of affected knee joint was largely improved in both groups at the 4th and 8th week postoperatively,which was significantly improved at the two indicated time points than baseline in either control group or treatment group.ROM of affected knee joint improved superb in treatment group at the 4th week postoperatively than that of control group(P<0.05),but the significant difference was not obtained at the 8th week(P>0.05).Lysholm knee score:Lysholm knee scores were obviously enhanced at the 4th and 8th week postoperatively than that before surgery in both groups.Notably,Lysholm knee scores at the 4th and 8th week postoperatively in either control group or treatment group were significantly higher than baseline(P<0.05),which were significantly higher at the 4th and 8th week postoperatively in treatment group than those of control group(P<0.05).Clinical efficacy:There were no significant differences in the clinical efficacy on repairing cartilage injury and the overall efficacy on clinical symptoms at the 8th week postoperative between groups(P>0.05).The overall efficacy on clinical symptoms at the 4th week was significantly higher in treatment group than that of control group(P<0.05).Conclusions:Debridement and reshape of cartilage combined with postoperative guided training programs have a definite efficacy on the recovery of acute chondral injury of patellar joint with the syndrome of Qi and blood obstruction,which effectively alleviate the pain of affected knee joint,restore the ROM,increase the score of knee joint function.It has no obvious effect on repairing injured cartilage. |
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