[Treatment of Pes anserinus bursitis with debridement under arthroscopy].

OBJECTIVE: To explore the clinical effectiveness of debridement in treatment of Pes anserinus bursitis under arthroscopy by comparing the curative effect of three therapies: local block therapy, open operation and debridement under arthroscopy.

METHODS: From January 2000 to January 2007, 90 cases of unilateral Pes anserinus bursitis were treated with debridement under arthroscopy (group A, n=30), local block therapy (group B, n=30) and open operation (group C, n=30), respectively. The group A included 18 males and 12 females, aged (40.0 +/- 2.5) years old; the locations were left knee in 16 cases and right knee in 14 cases; 10 cases had injury history, 7 cases had tired history and 13 cases had no obvious inducement; the course of disease was (24.0 +/- 3.2) weeks. The group B included 17 males and 13 females, aged (37.0 +/- 2.5) years old; the locations were left knee in 15 cases and right knee in 15 cases; 10 cases had injury history, 8 cases had tired history and 12 cases had no obvious inducement; the course of disease was (26.3 +/- 3.5) weeks. The group C included 16 males and 14 females, aged (39.8 +/- 2.2) years old; the locations were left knee in 18 cases and right knee in 12 cases; 8 cases had injury history, 10 cases had tired history and 12 cases had no obvious inducement; the course of disease was (25.0 +/- 3.9) weeks. There was no statistically significant difference in the general data among three groups (P > 0.05).

RESULTS: All patients were followed up 15 months on average (12-24 months). In group C, the inflammatory reaction occurred at wound in 9 cases (30%) at 3-10 days after operation and was cured after symptomatic management; other incision healed by first intention; and showing statistically significant differences when compared with other 2 groups (P < 0.05). In group C, joint swelling occurred at 1 week after operation in 1 case, limitation of joint motion in 2 cases at 10-12 weeks after operation and was recovered after symptomatic management. In group B, 21 cases (70%) had a recurrence at 6-12 months after operation, all patients of other 2 groups had no recurrence; showing statistically significant differences between group B and groups A, C (P < 0.05). At last follow-up, the pain remain rates were 3.3% (group A), 0 (group B) and 33.3% (group C), and the complication incidence rates were 3.3%, 26.7% and 70.0%, respectively; all showing statistically significant differences among three groups (P < 0.05). At last follow-up, there were statistically significant differences in the visual analogue scale (VAS) score, the HSS score, and range of motion (ROM) between preoperation and postoperation in group A (P < 0.05); there was no statistically significant difference in the VAS score, HSS score and ROM between preoperation and postoperation in group B (P > 0.05); the ROM of postoperation in group C was smaller than that of preoperation (P < 0.05). There were statistically significant differences in the VAS score and HSS score between group A and groups B, C (P < 0.05), and in ROM among three groups after operation (P < 0.05).

CONCLUSION: The treatment of Pes anserinus bursitis with debridement under arthroscopy has advantages of easy-to-do, less complication, low relapse rate and good functional rehabilitation.