Frontiers in Medical Science Research, 2021, 3(1); doi: 10.25236/FMSR.2021.030108.
Huang Wen, Ma Shiting, Huang Zhifu, Ou Ning, Liang Dadi, Zhong Jiayun, Jiang Zihao, Li Zhaofei
Hezhou People's Hospital, Hezhou, Guangxi 542899, China
Objective To study the clinical effect of arthroscopic knee joint cleansing for gouty knee arthritis.Methods A total of 80 patients with gouty knee arthritis treated in our hospital from January 2017 to December 2018 were selected. Among them, 42 patients underwent arthroscopic knee debridement in addition to drug treatment, and the other 38 patients were treated conservatively (medicine, physiotherapy, acupuncture and other treatments were given depending on the diagnosis and treatment guidelines).The knee joint VAS score and Lysholm score of all patients were collected before surgery (for conservatively treated patients at the initial visit) and after surgery (after the initial visit) at 1 and 12 months.Results In the arthroscopic surgery group, the VAS score and Lysholm score at the first month after operation was 4.45±0.90, 70.07±8.34, and the VAS score and Lysholm score at the 12th month after operation was 2.35±0.91, 80.59±10.55. The postoperative VAS score and Lysholm score of the arthroscopy group were significantly different from those before the operation (P<0.05).In the conservative treatment group, the VAS score and Lysholm score at the first month after treatment was 5.69±0.93, 58.61±12.12, and the VAS score and Lysholm score at the 12th month after treatment was 3.09±1.02, 70.42±9.54. The VAS score and Lysholm score of the conservative treatment group were significantly changed after treatment (P<0.05).However, throughout the follow-up period, the arthroscopic surgery group scored more significant changes than the conservative treatment group, while the arthroscopic surgery group had more significant changes in the first month after treatment (P<0.05).Conclusion Arthroscopic knee joint cleansing is more effective in treating gouty knee arthritis than conservative treatment, and it has an obvious effect early after surgery.
Gouty knee arthritis, arthroscopic surgery, conservative treatment,Efficacy analysis
Huang Wen, Ma Shiting, Huang Zhifu, Ou Ning, Liang Dadi, Zhong Jiayun, Jiang Zihao, Li Zhaofei. A comparative study of the efficacy of arthroscopic surgery and conservative treatment of gouty knee arthritis. Frontiers in Medical Science Research (2021) Vol. 3 Issue 1: 45-49. https://doi.org/10.25236/FMSR.2021.030108.
[1]Zhang Ge, Yan Bing, Wu Husheng (2018). Differential diagnosis of gouty arthritis. Chinese Journal of Practical Internal Medicine (12), 1123-1126.
[2]Karaarslan Ahmet,Kobak Senol, Berdeli Afig.(2016).NOD2/CARD15 gene mutations in patients with gouty arthritis. Bosnian journal of basic medical sciences(4).
[3] Yuan Ruyu, Chen Ying, Peng Yongde, Xu Huanbai (2019). Research progress in the mechanism of spontaneous regression of acute gouty arthritis. Chinese Journal of Endocrinology and Metabolism (05), 431-434.
[4]Chilappa CS,Aronow WS,Shapiro D (2010).Gout and hyperuricemia. Comprehensive therapy,36():3-13.
[5] Fan Meng, Jiang Wenxue (2019). Current status of surgical treatment of gouty knee arthritis. Chinese Journal of Orthopaedics (07), 623-626.
[6] Zeng Xiaofeng, Chen Yaolong (2016). 2016 Chinese Gout Diagnosis and Treatment Guidelines. Chinese Journal of Internal Medicine (11), 892-899.
[7] Sun Mingshu, Mu Yiming, Zhao Jiajun, Teng Weiping, Li Changgui (2019). Analysis of the current status of Chinese clinical guidelines and introduction to the formulation of "Guidelines for the diagnosis and treatment of hyperuricemia and gout in China (2018)". Chinese Journal of Endocrinology and Metabolism (03),181-184.
[8] Georg Schett,,Christine Schauer,,Markus Hoffmann & Martin Herrmann (2015). Why does the gout attack stop? A roadmap for the immune pathogenesis of gout. RMD Open(Suppl 1).
[9] Schlesinger (2010). Diagnosing and Treating Gout: A Review to Aid Primary Care Physicians. Postgraduate Medicine(2).
[10] Khanna PP,Gladue HS,Singh MK (2014).Treatment of acute gout: a systematic review.Seminars in arthritis and rheumatism,44(1):31-38.
[11] Zhang Shaofeng, Zhang Zhenwen, Ma Hongshan, Dong Juan, Che Qi, Chen Weiwei (2009). Clinical features and high-risk factors analysis of primary gout. Shandong Medicine (28), 62-63.
[12] Abhishek Abhishek, Doherty Michael (2018).Education and non-pharmacological approaches for gout.. Rheumatology (Oxford, England)(suppl_1).
[13] Hu Weiqiong, Cheng Hongyu, Wei Rongrui, Zhong Guoyue, Ai Yongqiang, Wang Deyun, Zhu Jixiao (2019). Research progress in molecular mechanisms of gout in the acute and chronic phases. New Chinese Medicines and Clinical Pharmacology (03),379-384.
[14] Sergey Aksenov,Carl C, Peck,Ulf G, Eriksson, Donald R, Stanski (2018).Individualized treatment strategies for hyperuricemia informed by a semi-mechanistic exposure-response model of uric acid dynamics. Physiological Reports(5).
[15] Li R,Yu K (2018).Dietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic review.Asia Pacific journal of clinical nutrition,27(6):1344-1356.
[16] Schlesinger N,Dalbeth N (2009).Gout--what are the treatment options?.Expert opinion on pharmacotherapy,10(8):1319-1328.
[17] ]Wilson L (2016).Gouty Arthritis: A Review of Acute Management and Prevention.Pharmacotherapy,36(8):906-922.
[18] Richette P,Doherty M,Pascual (2017).2016 updated EULAR evidence-based recommendations for the management of gout.Annals of the rheumatic diseases,76(1):29-42.
[19] Khanna D,Fitzgerald JD,Khanna PP (2012).2012 American College of Rheumatology guidelines for management of gout Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia.Arthritis care & research,64(10):1431-1446.
[20] Chen HW,Chen KC (2012).Colchicine and NSAID combination causing acute kidney injury.Journal of the College of Physicians and Surgeons--Pakistan : JCPSP,22(11):737-739.
[21] Schlee S,Bollheimer LC,Bertsch T (2018).Crystal arthritides - gout and calcium pyrophosphate arthritis : Part 1: Epidemiology and pathophysiology.Zeitschrift für Gerontologie und Geriatrie,51(4):453-460.
[22] Schlee S,Bollheimer LC,Bertsch T (2018).Crystal arthritides - gout and calcium pyrophosphate arthritis : Part 3: Treatment. Zeitschrift für Gerontologie und Geriatrie,51(6):703-710.
[23] Kasper IR,Juriga MD,Giurini JM (2016).Treatment of tophaceous gout: When medication is not enough.Seminars in arthritis and rheumatism,45(6):669-674.
[24] Zhu Peihai, Hou Jinfu, Xiong Bingming (2018). Clinical observation of knee arthroscopy in the treatment of gouty knee arthritis. Chinese Emergency Medicine, 38(z2):203.
[25] Yao Zhipeng, Lin Jiajun, Liu Wenge, Chen Min (2019). Application of arthroscopic minimally invasive surgery in the diagnosis and treatment of gouty knee arthritis. Chinese Journal of Bone and Joint Injury (12), 1306-1307.