Clinical efficacy analysis of arthroscopic cleanup for the treatment of knee osteoarthritis pain Objective To verify the clinical efficacy of arthroscopic cleanup for the treatment of osteoarthritis pain. Methods Seventy-eight patients with osteoarthritis of the knee joint were retrospectively analyzed and divided into 44 cases in the arthroscopic group and 34 cases in the control group for clinical comparative observation. Results The CR+PR rates of the arthroscopic group and control group were 86.3% and 35.3% respectively P<0.05 The difference between the two groups was statistically significant. Conclusion Knee arthroscopic cleanup is an effective treatment for relieving osteoarthritis pain in the knee joint. Osteoarthritis is a common chronic active disease in clinic, the etiology and pathogenesis are not clear, the lesions often involve the articular cartilage, synovium and subchondral bone and other tissues, there are a variety of clinical treatments 〔1〕 Knee arthroscopy is a minimally invasive treatment for knee joint disorders, with small trauma, short course of treatment, and good effect, the author used arthroscopic cleanup since March 2006-March 2007 to treat knee osteoarthritis, and it is an effective treatment to relieve the pain of knee joint osteoarthritis. The author used arthroscopic clean-up surgery to treat knee osteoarthritis from March 2006 to March 2007, and observed 78 cases to achieve good results, now reported as follows: Data and Methods 1, Clinical Data 1.1, General Data In the patients hospitalized with knee osteoarthritis pain from March 2006 to March 2007, 78 patients with pain were screened according to the pain assessment standard of VAS, and were randomly divided into 44 cases in the arthroscopic group and 34 cases in the control group, and 44 cases in the two groups. The two groups were aged 45-65 years old, average age 55 years old, with the longest disease duration of 4 years and the shortest of 3 months. There was no statistically significant difference in age, gender, location and X-ray staging between the two groups before treatment by ANOVA, and there was no statistically significant difference in the comparison of the pain classification between the two groups of patients. 1.2 Diagnostic Criteria According to the diagnostic criteria of OA in the knee joints proposed by the American College of Rheumatology (ACR) [2]: Knee pain, bone swelling formation, active movement of the knee joint, and pain in the knee joint. X-ray examination: all patients had weight-bearing knee axial patellofemoral radiographs, and the X-ray staging was as follows: early stage of osteosclerosis and osteophyte formation, without joint space narrowing. Intermediate stage: narrowing or loss of joint space. Late stage: wear and tear or loss of the weight-bearing surface of the tibia 1.3 Methods General anesthesia or epidural anesthesia was used, and the standard approach to the knee joint as described by Jackson [3] was followed, and various structures and lesions in the knee joint cavity were examined sequentially, and the surgery included joint cleaning, free body removal, cartilage molding, resection of the medial synovial folds, partial excision of the synovial membrane, inter-condylar fossa molding, excision of part of the osseous residue, and drilling of the subchondral bone. Intraoperative large amount of saline continuous irrigation of the joint cavity, usually about 6000ml, wound suture 1 needle, the second postoperative day down, quadriceps muscle functional exercise, 1 week removal of the stitches discharged. 1.4, efficacy standards: using VAS [4] pain relief efficacy assessment criteria ① complete relief (CR) refers to the disappearance of pain; ② partial relief (PR) pain is significantly reduced, does not affect sleep, do not need to use painkillers; ③ mild relief (MR) pain is reduced, but it is still obvious that the need for painkillers; ④ ineffective (NR) pain is not reduced or aggravated by the treatment, the total healing rate = CR + PR, the total healing rate of patients in both groups, the total effective rate of pain relief. Comparison of the total effective rate of pain relief between the two groups of patients was performed by chi-square test, and the number of effective days since the beginning of pain relief was expressed by mean + standard deviation (X + S). 2. Results 2.1 Subjective satisfaction The statistics were performed according to satisfaction, general, and dissatisfaction. Satisfaction means that patients think that their symptoms have significantly improved after surgery, general means that patients' symptoms have not significantly improved after surgery, and dissatisfaction means that they are not satisfied with the surgery or still have obvious symptoms. In the arthroscopy group, 32 cases (72.7%) were satisfied, 9 cases (20.4%) were fair, and 3 cases (6.8%) were unsatisfied. Discussion Osteoarthritis is the most common type of arthritis, and its incidence is on the rise as our country enters the aging age. Patients with osteoarthritis of the knee joint have difficulty walking due to pain, which affects their quality of life. The true etiology of the disease is not clear, but it is certain that it is caused by degeneration of the articular cartilage. Knee arthroscopy is a minimally invasive treatment method for knee joint disorders, with small trauma, short course of treatment and good effect, it has an important status and deserves in-depth study [5-7] Clinical arthroscopic cleaning of the knee joint, mainly through a large number of physiological saline irrigation of the knee joint cavity, to remove the disease-causing lesion tissues and inflammatory mediators in the joints, which can be worn out articular surfaces trimming and shaping, meniscus trimming and adhesion In addition, a large amount of saline irrigation with certain pressure in the operation not only removes necrotic tissues and debris, but also replenishes electrolytes such as Na, K, Ca, Mg, etc., and regulates the pH and osmotic pressure of the joint fluid, which improves the internal environment of the joints, increases the nutrition of cartilage, and interrupts the vicious circle of osteoarthritis, which is very important for the treatment of osteoarthritis, especially for the treatment of osteoarthritis. It has definite efficacy in the treatment of osteoarthritis, especially in the relief of pain. We observed that the arthroscopic group had a significant advantage over the control group in terms of both the efficacy of pain relief and the number of days to the onset of significant effects. It should be noted that arthrocentesis is only a palliative rather than a radical surgery. It is a method between conservative treatment and joint replacement, and its advantages are minimally invasive, does not disturb the physiological function of the joint, and has fewer complications, which are favored by doctors and patients. We conclude that arthroscopic cleanout is an important method for the treatment of osteoarthritis of the knee, which can relieve pain and has diagnostic value for chronic knee osteoarthritis [8] Arthroscopic cleanout for osteoarthritis is mainly to reduce pain, so subjective satisfaction assessment is more important, and the subjective satisfaction in foreign literature is about 70% [9] which is similar to our results. However, the indications should be strictly controlled, because the cause cannot be completely removed and normal anatomy restored, the long-term effect is poor, and arthroplasty should be performed if necessary.