ABSTRACT
Objective::To observe the clinical efficacy of modified Simiaosan on synovitis of knee joint with damp-heat obstruction collateral syndrome and the effect on inflammatory factors and neuropeptide substances in synovial fluid. Method::One hundred and thirty-five patients were randomly divided into control group(67 cases) and observation group(68 cases) by random number table. Patients' intra-articular effusion was drawn out. Triamcinolone acetonide was injected into arthrosis for 2 times, 1 time/week, and aceclofenac sustained-release tablets were given for 4 weeks, 0.2 g/time, 1 time/day. In addition to the therapy of control group, patients in observation group were also given modified Simiaosan for 4 weeks, 1 dose/day. Before and after treatment, pain, swelling of knee joint and were scored, Western Ontario and McMaster University (WOMAC) were adopted for scoring knee score, and damp-heat obstruction syndrome and local signs of knee joint were also assessed. And levels of interleukin-1 beta (IL-1 beta), IL-6, tumor necrosis factor-alpha (TNF-alpha), hypersensitive C-reactive protein (hs-CRP), substance P (SP), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) were detected. Result::After treatment, scores of pain and swelling of knee joint in observation group were lower than those in control group (P<0.01). Scores of WOMAC, the total score, integral of damp-heat obstruction collateral syndrome, knee flexion-extension range score and floating patella test were all lower than those in control group (P<0.01). And levels of IL-1β, IL-6, TNF-α, hs-CRP, SP, CGRP, NPY and VIP were all lower than those in control group (P<0.01). Analyzed by rank sum test, the clinical efficacy in observation group was better than those in control group (Z=2.089, P<0.05). Conclusion::Modified Simiaosan can significantly alleviate pain and swelling symptoms, promote the recovery of knee joint function, and inhibit the expressions of proinflammatory factors and neuropeptides in synovial fluid, with a better clinical efficacy.
ABSTRACT
RESUMEN El trabajo que se realizó tiene como objetivo proponer ejercicios terapéuticos y masaje que contribuyan al tratamiento de la sinovitis de rodilla en pacientes que asisten al área terapéutica de la Facultad de Cultura Física «Nancy Uranga Romagoza¼, Pinar del Río; teniendo en cuenta que a pesar de un mes de tratamiento los pacientes presentaban limitación articular, claudicación de la marcha y disminución del tono de los músculos que participan en los movimientos de esa articulación, lo que influye negativamente en la rehabilitación de su lesión. El empleo de métodos teóricos como histórico-lógico, análisis-síntesis e inductivo-deductivo; de métodos empíricos como el análisis con documentos y la medición, así como los métodos estadísticos, posibilitaron constatar las limitaciones en la amplitud articular de la rodilla lesionada, además estructurar la propuesta cuyos ejercicios terapéuticos tienen como principios entre otros, la regulación de las cargas, la sistematicidad e ir de lo simple a lo complejo; estructurada en dos etapas, inicial y avanzada, así como la vinculación con el masaje, de forma tal que incida positivamente en la recuperación del paciente, constatando la utilidad en su aplicación. Se hace alusión a la importancia de la participación activa del lesionado para la efectividad de la terapia y recomienda continuar el estudio de los factores que influyen en un mejor tratamiento rehabilitador para pacientes con sinovitis de rodilla.
ABSTRACT This work is aimed at proposing therapeutic exercises and massages to contribute to the treatment of the knee synovitis in patients who assisted tothe therapeutic area of the Physical Culture Faculty «Nancy UrangaRomagoza¼, Pinar del Río; Taking into account that in spite of a month of treatment the patients presented limitation to articulate, reduction of the walk motion and decrease of the muscular tone of the muscles that participate in the movements of that articulation, influencing negatively in the rehabilitation of their injury. The usage of theoretical methods as historical-logical, analysis-synthesis and inductive-deductive; of empiric methods as the analysis with documents and the measuring experiment, as well as the statistical methods, facilitated to verify the limitations in the joint width around the injured knee, also to structure the proposal whose therapeutic exercises having as a principle, the regulation of the loads increasing gradually the complexity levels, structured in two stages, initial and advanced, as well as the linking to the massage, in such way that impacts positively in the patient's recovery. In the conclusions there is a reference to the importance of the patient´s active participation on behalf of the effectiveness of the therapy and it is recommended to continue the study of the factors that determine a better rehabilitation treatment for patients suffering knee synovitis.
ABSTRACT
Objective To investigate effects analysis of joint function and MMP-7 and MMP-9 measurement after synovial ar-throscopic debridement for knee synovitis.Methods 72 patients with knee synovitis method based on a random draw were e-qually divided into the treatment group and the control group,the control group were given the traditional synovial planing surgery.The treatment group were given the arthroscopic debridement synovium.Results After treatment,the response rates in the treatment group and the control group were 97.2% and 80.6% respectively.The response rate of the treatment group were significantly better than the control group.The difference was statistically significant (P <0.05).The postopera-tive Lysholm scores were increased significantly,while the pain scores were significantly reduced,and the postoperative Ly-sholm score and pain scores difference compared between the two groups were also statistically significant.The difference was statistically significant (P <0.05).The postoperative synovial tissue MMP-7 and MMP-9 expression rates were in the two groups significantly lower.The difference was statistically significant (P <0.05),while the postoperative MMP-7 and MMP-9 expression rates of the treatment group were ignificantly lower than the control group (P <0.05).Conclusion Syn-ovial arthroscopic debridement for knee synovitis can relieve pain and improve knee function,reduce the expression of MMP-7 and MMP-9,thereby enhance the overall efficacy of the treatment.
ABSTRACT
Tuberculosis of the appendicular skeleton is an uncommon infection by tubercle bacilli. Thirty percent of the skeletal tuberculosis involves joints, the knee being the third most common joint affected. We report a case of tuberculous synovitis of the knee joint in a 69 years old male. The diagnosis was done by Ziehl – Neelsen stain and culture on Lowenstein – Jensen medium of the synovial fluid along with X-ray finding of the knee joint. Though the sputum sample was negative for AFB, X-ray of the chest showed finding suggestive of old pulmonary tuberculosis. The patient was treated with the anti tubercular regimen and responded well .