To investigate the clinical effect of arthroscopic debridement combined with intra-articular drug injection in the treatment of knee osteoarthritis (KOA).

Sixty patients who underwent arthroscopic debridement in Beijing Nuclear Industry Hospital due to KOA from October 2015 to October 2019 were analyzed retrospectively. According to different treatment methods, they were divided into the control group (n=30) and the experimental group (n=30). The control group was treated with arthroscopic debridement. Under the corresponding anesthesia, the conventional anterior medial and lateral approaches of the knee were used to make a surgical incision with a length of about 5 mm, and the affected knee was punctured. After the puncture was successful, the arthroscopic protective sleeve was placed, an appropriate amount of perfusion fluid was injected to expand and fill the joint cavity, and then the arthroscopic lens was placed to observe the situation. According to the condition of intra-articular lesions, and the loose body was taken out. The joint cavity was rinsed, the fluid in the joint cavity was vacuumed, and then the compression dressing incision was sutured. On the basis of arthroscopic debridement (the same as the control group), the experimental group was given 2 mL medical chitosan+ 1 mL compound betamethasone injection for intra-articular injection immediately after operation. After that, it was injected once every 2 weeks for a total of 3 consecutive times. The cases of joint swelling and reoperation in the two groups within 6 weeks after operation were observed and recorded. The degree of knee pain and knee function score were compared between the two groups before and 6 weeks after operation. The degree of knee pain was evaluated by visual analogue scale (VAS), and the knee function activity was evaluated according to Lysholm score standard. The levels of C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) inflammatory indexes were compared between the two groups at 6 weeks after operation. Data were processed with independent sample t test, paired sample t test and chi-square test.

The operation was successful in 60 patients. Within 6 weeks after operation, there were 1 case severe, 2 cases moderate and 2 cases mild joint swelling in the control group, and 1 case moderate and 2 cases mild joint swelling in the experimental group, but there was no statistically significant difference (χ²=1.347, P=0.246). Within 6 weeks after operation, 9 cases in the control group and 8 cases in the experimental group were reoperated. There was no statistically significant difference in the number of reoperated cases (χ²=1.405, P=0.263). The VAS score of the control group was significantly lower than that before operation, while the Lysholm score was significantly higher than that before operation (t=12.385, 9.173; P<0.05). The change trend of VAS score and Lysholm score in the experimental group before and after operation were the same as those in the control group (t=13.665, 11.196; P<0.05). There were no statistically significant differences in VAS score and Lysholm score between the two groups before operation (t=0.174, 0.105; P>0.05). Six weeks after operation, the VAS score [(2.47±1.13) points] in the experimental group was lower than that in the control group [(3.25±1.37) points], while the Lysholm score [(86.36 ± 11.05) points] was higher than that in the control group [(73.14 ±12.08) points], and the differences were statistically significant (t=7.301, 5.415; P<0.05). Six weeks after operation, CRP, IL-6 and TNF-α in the experimental group were (11.13±3.36) mg/L, (2.03±0.22) ng/L and (4.92 ± 2.56) pg/mL respectively, which were lower than those in the control group [(14.75 ± 5.32) mg/L, (5.17±1.94) ng/L and (7.18±1.98) pg/mL], the differences were statistically significant (t=3.938, 5.125, 6.741; P<0.05).

Arthroscopic debridement combined with medical chitosan and compound betamethasone injection in the treatment of KOA can effectively alleviate pain and improve knee function and activity, and the curative effect is satisfactory.