Efficacy of ultrasound-guided knee joint nerve block combined with small needle knife on knee osteoarthritis
Objective It is to investigate the clinical efficacy of ultrasound-guided knee nerve block combined with small needle knife in the treatment of knee osteoarthritis.Methods Ninety patients diagnosed with knee osteoarthritis in the Pain Department of Shanghai Minhang District Central Hospital and the Pain Department of Zepu County People's Hospital from January to June 2023 were selected for the study.The patients were divided into nerve block group,small needle knife group and nerve block combined with small needle knife group(combination)by randomized table method,with 30 cases in each group.The nerve block group was treated with nerve block in the upper inner,lower inner,outer upper and lower outer knee joints under ultrasound guidance;the small needle knife group was treated with small-needle knife stimulation to loosen the diseased muscles of the knee joints under ultrasound guidance,and the combination group was treated with ultra-sound-guided knee nerve block combined with small needle knife.The clinical efficacy of the three groups was compared at 3 months after treatment,and the pain VAS score,WOMAC score,and flexion and extension angle of knee joint on the af-fected side during walking were observed in the three groups before treatment and at 1 month,3 months,and 6 months after treatment,and the occurrence of the adverse reactions such as infection,puncture distension and pain and subcutaneous emphysema in the three groups were counted after treatment.Results At 3 months after treatment,the healing rate and o-verall effective rate of the combination group were significantly higher than those of the nerve block group and small needle knife group[76.67%(23/30)VS.16.67%(5/30),63.33%(20/30),93.33%(28/30)VS.73.33%(22/30),86.67%(26/30),all P<0.05];at 1,3,and 6 months after surgery,the VAS scores and WOMAC scores of patients in the three groups were significantly lower than those before treatment(all P<0.05),and the combination group was signifi-cantly lower than the nerve block group and small needle knife group at the same time point(all P<0.05).At 1 month,3 months and 6 months after treatment,the maximum knee flexion angles of the three groups were significantly greater than those before treatment(all P<0.05),and the combination group was significantly greater than the nerve block group and small needle knife group at the same time point(all P<0.05);the minimum knee flexion angles of the three groups were significantly smaller than those before treatment(all P<0.05),and the combination group was significantly smaller than the nerve block group and small needle knife group at the same time point(all P<0.05).The incidences of adverse reac-tions in both the combination group and nerve block group were significantly lower than that in the small needle knife group(P<0.05).Conclusion Nerve block combined with small needle knife is effective in the treatment of knee osteoarthritis,it can effectively allieviate pain and increase the mobility of knee joint,and ultrasound guidance can ensure the accuracy,effectiveness and safety of the treatment to a great extent.
万方数据
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