퇴행성 슬관절염의 관절경적 치료

Purpose: To evaluate the efficacy and the prognostic factors in arthroscopic treatment of degenerative arthritis of the knees Materials and Methods: The results of 115 knees in 110 patients had been treated arthroscopically from Jan. 1990 to June 1999 were analysed. Mean age was 56 years old and mean follow-up period was 1 years 9 months(range: 1 year-7 year). Pain, Range of motion, Lysholm score, and changes of subjective symptoms were assessed for clinical evaluation, Preoperative and postoperative X-rays of the knees and arthroscopic findings were also reviewed and statistical analysis was performed. We tried to find out the clinical results and prognostic factars in arthroscopic treatment of the degenerative arthritis. Results: The best clinical improvement was observed in postoperative 1-2 year period and the clinical improvement was continued by 3 years after surgery. Sixty two percents of patients had significant improvement of subjective symptoms for 1-2 year postoperatively, and 52% for at least 3 years after surgery. The patients of younger age, normal weight, normal alignment of lower leg(1°-7° degree of tibio-femoral angle) and shorter duration of preoperative symptoms showed better clinical results. Eighty percents of improvement of subjective symptoms has been obseved in the group of patient who had the mechanical symptoms preoperatively. In the knee with mild cartilage degeneration(according to Jack- sons classification, stage I or g ) and with torn meniscus showed better clinical improvement after surgery compared with those of severe cartilage degeneration or intact menisci. Conclusion: Arthroscopic treatment can be considered as a succesful treatment method for temperary relief of symptoms in the degenerative arthritis of knees. However, careful selection of patients looks mandatory for favorable results. The favorable prognostic factors in the study were younger age, no obesity, shorter duration of symptoms, nearly normal alignment of knees, less cartilage degeneration, mechanical symptoms, and torn meniscus.