BMJ:运动疗法是否优于关节镜下半月板部分切除?

2016-07-21 崔倩 译 MedSci原创

该研究的目的是确定对于中老年退行性半月板损伤患者的膝关节功能,运动疗法是否优于关节镜下半月板部分切除。原始出处:Nina Jullum Kise, May Arna Risberg,Silje Stensrud,et al.Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear

该研究的目的是确定对于中老年退行性半月板损伤患者的膝关节功能来说,运动疗法是否优于关节镜下半月板部分切除。

来自挪威的研究人员进行了一项随机对照试验。该研究在挪威两所公立医院和两个物理治疗诊所的骨科部门进行。该研究纳入140名成人参与者,其平均年龄49.5岁(范围35.7-59.9),这些参与者患有磁共振成像确定的退行性内侧半月板撕裂。96%的人没有明确的骨关节炎影像学证据。干预措施为单独12周的监督运动治疗或单纯关节镜下半月板部分切除术。

膝盖受伤和骨关节炎结果评分(KOOS4)变化的组间差异使用意向性治疗进行分析,确定一个先验作为从基线到两年随访时的变化(疼痛,其他症状,运动和娱乐功能,和膝关节相关生活质量)和大腿肌肉力量从基线到三个月的变化KOOS量表得分五分之四的平均分数。

在两年时,两组间KOOS4变化无临床相关的差异(0.9分,95%可信区间为-4.3至6.1; P=0.72)。在三个月时,运动组的肌肉力量得到了改善(P≤0.004)。在两年随访期间任一组中没有严重的不良事件发生。19%的参与者在两年随访期间没有进行手术而被分配接受运动疗法,但并没有得到额外的益处。

在两年随访中,观察到的治疗效果差异只是瞬间的,试验的不确定性推断是非常小的,并排除了临床相关的差异。运动疗法显示出可以改善大腿肌肉的力量,至少在短期内有积极影响。该研究结果鼓励医生和没有明确的影像学证据的中老年退行性半月板撕裂和骨关节炎患者,考虑将监督性运动疗法作为一种治疗选择。

原始出处:


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encodeId=7e00141886265, content=<a href='/topic/show?id=9cd3301521d' target=_blank style='color:#2F92EE;'>#关节镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30152, encryptionId=9cd3301521d, topicName=关节镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7693435830, createdName=xzw114, createdTime=Fri Jul 22 23:37:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778529, encodeId=c7421e7852939, content=<a href='/topic/show?id=008a3015303' target=_blank style='color:#2F92EE;'>#关节镜下半月板部分切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30153, encryptionId=008a3015303, topicName=关节镜下半月板部分切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5b139296566, createdName=天堂的云, createdTime=Wed Jul 27 00:37:00 CST 2016, time=2016-07-27, status=1, ipAttribution=)]
    2017-04-01 gaoxiaoe
  2. 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    2016-09-17 1e10c84am36(暂无匿称)

    不错哦,会学到很多,喜欢梅斯医学文章

    0

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encodeId=7e00141886265, content=<a href='/topic/show?id=9cd3301521d' target=_blank style='color:#2F92EE;'>#关节镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30152, encryptionId=9cd3301521d, topicName=关节镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7693435830, createdName=xzw114, createdTime=Fri Jul 22 23:37:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778529, encodeId=c7421e7852939, content=<a href='/topic/show?id=008a3015303' target=_blank style='color:#2F92EE;'>#关节镜下半月板部分切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30153, encryptionId=008a3015303, topicName=关节镜下半月板部分切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5b139296566, createdName=天堂的云, createdTime=Wed Jul 27 00:37:00 CST 2016, time=2016-07-27, status=1, ipAttribution=)]
    2016-09-07 李东泽

    中老年退行性半月板撕裂和骨关节炎进行【监督性的运动疗法】

    0

  4. 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encodeId=7e00141886265, content=<a href='/topic/show?id=9cd3301521d' target=_blank style='color:#2F92EE;'>#关节镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30152, encryptionId=9cd3301521d, topicName=关节镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7693435830, createdName=xzw114, createdTime=Fri Jul 22 23:37:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778529, encodeId=c7421e7852939, content=<a href='/topic/show?id=008a3015303' target=_blank style='color:#2F92EE;'>#关节镜下半月板部分切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30153, encryptionId=008a3015303, topicName=关节镜下半月板部分切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5b139296566, createdName=天堂的云, createdTime=Wed Jul 27 00:37:00 CST 2016, time=2016-07-27, status=1, ipAttribution=)]
    2016-09-07 李东泽

    很好,不错,以后会多学习

    0

  5. 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encodeId=7e00141886265, content=<a href='/topic/show?id=9cd3301521d' target=_blank style='color:#2F92EE;'>#关节镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30152, encryptionId=9cd3301521d, topicName=关节镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c7693435830, createdName=xzw114, createdTime=Fri Jul 22 23:37:00 CST 2016, time=2016-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1778529, encodeId=c7421e7852939, content=<a href='/topic/show?id=008a3015303' target=_blank style='color:#2F92EE;'>#关节镜下半月板部分切除#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30153, encryptionId=008a3015303, topicName=关节镜下半月板部分切除)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5b139296566, createdName=天堂的云, createdTime=Wed Jul 27 00:37:00 CST 2016, time=2016-07-27, status=1, ipAttribution=)]
    2016-08-30 ylzr123

    好文,值得学习,赞!

    0

  6. 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    2016-07-22 xzw114
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