[1]闫国富,薛晨晖,刘巍.腓骨近端截骨术治疗不同外翻应力角膝关节骨关节炎患者的疗效比较[J].中华老年骨科与康复电子杂志,2017,(01):38-42.[doi:10.3877/cma.j.issn.2096-0263.2017.01.008]
 Yan Guofu,Xue Chenhui,Liu Wei.Comparison of the VgSA and the efficacy of knee osteoarthritis treated by proximal fibular osteotomy[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):38-42.[doi:10.3877/cma.j.issn.2096-0263.2017.01.008]
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腓骨近端截骨术治疗不同外翻应力角膝关节骨关节炎患者的疗效比较()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年01期
页码:
38-42
栏目:
“不均匀沉降理论”在骨关节炎中的应用
出版日期:
2017-02-05

文章信息/Info

Title:
Comparison of the VgSA and the efficacy of knee osteoarthritis treated by proximal fibular osteotomy
作者:
闫国富薛晨晖刘巍
030600 山西省晋中市第一人民医院骨科
Author(s):
Yan Guofu Xue Chenhui Liu Wei
Department of Orthopedics, Jinzhong First People’s Hospital, Jinzhong 030600, China
关键词:
膝关节 骨关节炎 腓骨 截骨术
Keywords:
Knee joint Osteoarthritis Fibular Osteotomy
DOI:
10.3877/cma.j.issn.2096-0263.2017.01.008
文献标志码:
A
摘要:
目的 探讨 X线测量膝关节外翻应力角(valgus stress angle,VgSA)与腓骨近端截骨术治疗膝关节骨关节炎疗效的关系。方法 前瞻性收集 2014年 11月至 2015年 5月山西省晋中市第一人民医院确诊为膝关节骨关节炎且符合纳入及排除标准的患者 35例(41膝),其中男性 2例,女性 33例,双膝 6 例。术前均拍下肢负重位全长片、测量非负重位 VgSA。根据 VgSA 角度将患者分为:<2°组、 2°~5°组、>5°组。分别于术后 3、6、12个月随访并比较三组患者术前与末次随访时的西安大略和麦克马 斯 特 大 学 骨 关 节 炎 指 数(western ontario and McMaster Universities osteoarthritis index, WOMAC)变化情况。结果 所有患者均获 6~13个月随访,平均(7.8±2.7)个月。三组患者手术时间比较,差异无统计学意义(P>0.05)。术前三组患者的 WOMAC指数相比差异无统计学意义(F=0.198, P>0.05),末次随访时,2°~5°组(15±5)患者的 WOMAC 指数小于<2(° 20±8)和>5°组(20±6),差异有统计学意义(F=4.032,P<0.05);且 2°~5°组(37%)的 WOMAC指数改善率高于>5°组(34%)及<2° 组(32%),差异有统计学意义(F=5.431,P<0.01)。结论 通过 VgSA 的测量有助于把握腓骨近端截骨术适应证,VgSA 介于 2°~5°之间的膝关节骨关节炎患者可获得更为满意的疗效。
Abstract:
Objective To compare the efficacy of proximal fibular osteotomy treating knee osteoarthritis at different valgus stress angle (VgSA). Methods From November 2014 to May 2015, 35 patients (41 knees) with knee osteoarthritis were treated with proximal fibular osteotomy in Jinzhong First People’s Hospital, including 2 males and 33 females and 6 bilateral knees. Before surgery, all patients were covered with weight-bearing full-length X-ray. At the same time, the VgSA were measured at nonweightbearing position. Patients were then divided into <2° group, 2°- 5° group and >5° group based on VgSA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were recorded before and at the last follow-up, comparsion was done to evaluate the efficacy of proximal fibular osteotomy. Results All cases were followed up for 6- 13 months (mean 7.8 ± 2.7 months). There was no significant difference of WOMAC between three groups (F=0.198, P>0.05) preopratively. At the last follow-up, the WOMAC in the 2°-5° group (15±5) were significantly lower than those in the <2° (20±8) and >5° group (20±6) (F=4.032, P<0.01), and WOMAC improvement rate in the 2°-5° group (37%) were also significantly lower than <2° (32% ) and >5° (34% ) group (F=5.431, P<0.05). Conclusion VgSA can be used in proximal fibular osteotomy to assure surgical outcoms, and knee osteoarthritis patients of 2°- 5° VgSA obtain more satisfactory therapeutic effect.

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备注/Memo

备注/Memo:
基金项目:晋中市科技攻关项目(81100293)
更新日期/Last Update: 2017-04-01