Clinical study of improvement of bone metabolism and knee function in patients with knee osteoarthritis by arthroscopic debridement combined with sodium hyaluronate

DU Zhonghua; XI Lifeng; ZHANG Hua

doi:10.3969/j.issn.1674-666X.2024.05.006

Abstract：Objective To explore the effect of arthroscopic debridement combined with sodium hyaluronate on bone metabolism and knee function in patients with knee osteoarthritis(KOA).Methods A total of 101 patients with KOA admitted to Yellow River Sanmenxia Hospital from October 2021 to August 2023 were divided into the combined group(n=51)and the control group(n=50)using random number table method.Patients in the control group received arthroscopic debridement,while patients in the combined group received arthroscopic debridement combined with intraarticular injection of sodium hyaluronate.The knee joint function of the two groups was compared at 6 months after operation.Bone metabolism indexes such as serum carboxyl-terminal telopeptide of type Ⅱ collagen(CTX-Ⅱ),cartilage oligomeric matrix protein(COMP)and osteoprotegerin(OPG),as well as C-reactive protein(CRP),interleukin(IL)-6 and intercellular adhesion molecule(ICAM)-1 in joint fluid were evaluated before operation and at 1,3 and 6 months after operation.The complications were recorded during the follow-up period.Results The excellent and good rate of knee joint function of the combined group was higher than that of the control group at 6 months postoperatively(P<0.05).The levels of serum CTX-Ⅱ and COMP of the two groups at all time points after operation were lower than those before operation(P<0.05).In combined group,serum CTX-Ⅱ levels at 1,3,6 months postoperatively and COMP levels at 3 and 6 months postoperatively were lower than those postoperative ones in the control group.Serum OPG amount in both groups was increased at all time points after operation when compared with those before operation,and the combined group was higher than the control group(P<0.05).The levels of CRP,IL-6 and ICAM-1 in joint fluid of the two groups were decreased at all time points after operation,and the combined group was lower than the control group(P<0.05).There was no statistical difference in total incidence of postoperative complications between the two groups(P>0.05).Conclusion Arthroscopic debridement combined with sodium hyaluronate in the treatment of KOA could safely improve the bone metabolism of patients,reduce inflammatory reaction and promote the recovery of knee joint function.