To investigate the clinical effect of knee osteoarthritis (KOA) treated by arthroscopic debridement combined with drug penetrationby internal and external knee point ultrasound and its effect on serum biochemical markers of bone metabolism and inflammatory markers.

Eighty patients with unilateral KOA of Kellgren& Lawrence grade Ⅱ to Ⅲ, from January 2018 to November 2019 in orthopedics department of Daxing Teaching Hospital of Capital Medical University were selected and the patients of severe knee joint stiffness or deformity and other diseases affecting lower limb function were excluded. The enrolled patients were divided into the observation group (n=40) and the control group (n=40) by simple random number table method. All the patients were treated with arthroscopic debridement, and the control group were treated with routine treatment, while the observation group were treated with the combination of internal and external knee point ultrasound and drug penetration besides the same routine treatment. The clinical effects of the two groups were evaluated after four weeks of continuous treatment. Before and after the treatment, the two groups were assessed by Lysholm knee joint scoring system, osteoarthritis index of Western Ontario and McMaster University (WOMAC) and visual analogue scale (VAS). The biochemical indexes of serum bone metabolism, including bone Gla protein (BGP), osteoprotegerin (OPG), receptor activator of neuclear factor-κB ligand (RANKL), inflammation markers levels such as interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α were detected by enzyme-linked immunosorbent assay. Finally, the complications and side effects of the two groups were summarized. Counting data between groups were analyzed by chi-square test and measurement data were analyzed by t test.

The total effective rate of the observation group [90.0% (36/40)] was significantly higher than that of the control group [67.5% (27/40)] (χ²=6.050, P<0.05). After the treatment, Lysholm score of the two groups was significantly higher than that of the group before treatment, while WOMAC score and pain VAS score were significantly lower than that of the group before treatment, but the improvement of the observation group was more significant (t =2.588, 5.541, 4.140, all P<0.05). After the treatment, the levels of BGP and OPG in serum of the two groups were significantly higher than those before treatment, while the levels of RANKL in serum of the two groups were significantly lower than those before treatment. The levels of BGP and OPG in serum of the observation group were significantly higher than those of the control group at the same time (t=6.717, 4.840, both P<0.05), while the levels of RANKL in serum were significantly lower (t=12.292, P<0.05). After treatment, the serum levels of IL-1β, IL-6 and TNF -α in the two groups were significantly lower than those before treatment, but the serum levels of the above inflammatory markers in the observation group were significantly lower than those in the control group at the same time (t=6.040, 8.744, 5.745, all P<0.05). There was no obvious complication or side effect in neither of the two groups after the operation.

After arthroscopic debridement combined with internal and external knee point ultrasound and drug penetration therapy, the overall effect of KOA is significant, which can significantly alleviate the pain, swelling and other symptoms of patients with knee joint, improve knee joint function.