[1]杨朝君 孙智文 田洪涛.腓骨近端截骨术与人工全膝关节置换术治疗内翻型膝关节骨关节炎的短期疗效比较[J].中华老年骨科与康复电子杂志,2016,(01):38-43.[doi:10.3877/cma.j.issn.2096-0263.2016.01.008]
　Yang Zhaojun,Sun Zhiwen,Tian Hongtao.Comparison on the short term treatment of varus knee osteoarthritis by proximal fibular osteotomy versus total knee arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):38-43.[doi:10.3877/cma.j.issn.2096-0263.2016.01.008]
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腓骨近端截骨术与人工全膝关节置换术治疗内翻型膝关节骨关节炎的短期疗效比较()
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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:
2016年01期
页码:
38-43
栏目:
临床论著
出版日期:
2016-02-05

文章信息/Info

Title:
Comparison on the short term treatment of varus knee osteoarthritis by proximal fibular osteotomy versus total knee arthroplasty
作者:
杨朝君 孙智文 田洪涛
内蒙古自治区赤峰市医院骨关节科；华中科技大学同济医学院附属协和医院骨科
Author(s):
Yang Zhaojun;  Sun Zhiwen;  Tian Hongtao
Department of Orthopaedics, Chifeng Municipal Hospital, Chifeng 024000, China; Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China
关键词:
膝关节; 　骨关节炎; 　腓骨; 　截骨术; 　关节成形术; 　置换; 　膝
Keywords:
Knee joint; 　Osteoarthritis; 　Fibular; 　Osteotomy; 　Arthroplasty;  replacement;  knee
DOI:
10.3877/cma.j.issn.2096-0263.2016.01.008
摘要:
目的　比较腓骨近端截骨术与人工全膝关节置换术（total knee replacement，TKA）治疗内翻型膝关节骨关节炎的短期疗效。方法　回顾性分析2015 年4 月至2015 年7 月内蒙古自治区赤峰市医院骨科接受腓骨近端截骨术与TKA 治疗的内翻型膝关节骨关节炎患者共103 例，符合纳入及排除标准的共85 例。根据接受的术式不同分为腓骨截骨组和TKA 组。腓骨截骨组患者40 例，男11 例（27.5%），女29 例（72.5%），年龄48 ～ 78 岁，平均（65.4±8.6）岁；TKA 组患者45 例，男14 例（31.1%），女31 例（68.9%），年龄52 ～ 81 岁，平均（64.3±7.6）岁。分别于术前、术后 7 d、1 个月、2 个月、3 个月随访并比较两组患者手术前后疼痛视觉模拟评分（visual analogue scale， VAS）、美国特种外科医院（hospital for special surgery，HSS）膝关节评分、血红蛋白、总失血量、输血量、手术时间、住院时间、住院期间总花费及观察术后并发症情况。结果　85 例患者获得满意随访，随访时间3 ～ 5 个月。与TKA 组患者相比，腓骨截骨组患者的总出血量、输血量、手术时间、住院时间、总花费较少（P ＜ 0.05）；与术前相比，术后两组患者的HSS 评分均明显升高、VAS 评分均显著降低（P ＜ 0.05），VAS 和HSS 评分的组间比较差异无统计学意义（P ＞ 0.05）；术后 TKA 组患者的血红蛋白含量明显降低（P ＜ 0.05），腓骨截骨组患者的血红蛋白含量无显著变化（P ＞ 0.05）。结论　腓骨近端截骨术可获得与TKA 相似的近期疗效，且具有创伤小、失血少、花费低、手术及住院时间短等优点，值得临床推广。
Abstract:
Objective　To compare the short-term result of proximal fibular osteotomy and total knee arthroplasty in the treatment of varus knee osteoarthritis. Methods　From April 2015 to July 2015, the retrospective analysis was performed on 103 patients who accepted proximal fibular osteotomy and total knee arthroplasty in Inner Mongolia chifeng city hospital. Among the 103 patients, 85 patients who reached the inclusion criteria were followed. All the patients were divided into two groups: the proximal fibular osteotomy group (group PFO) and the total knee arthroplasty group (group TKA). Group PFO contain 40 patients, with 11 male cases and 29 female cases. The average age was (65.4±8.6) years (from 48 to 78 years). Group TKA contain 45 patients, with 14 male cases and 31 female cases. The average age was (64.3±7.6) years (from 52 to 81 years). The VAS, The HSS knee score, hemoglobin changes 7 days after operation, total blood loss, amount of blood transfusion, operation time, hospitalization time, total cost during hospitalization, postoperative complications were recorded and compared between the two groups. Results　 85 patients were followed up for 3-5 months. The total blood loss, blood transfusion, operation time, hospital stay, total cost of hospitalization in group PFO were significantly less than those in group TKA (P<0.05). After operation, the HSS knee score of the two groups increased significantly (P<0.05), and the VAS score decreased significantly (P<0.05). The hemoglobin content in the TKA group decreased significantly (P<0.05), while the patients in the proximal fibula osteotomy group had no significant change (P>0.05). Conclusions　 Proximal fibula osteotomy has the similar short term effect with the total knee replacement and has the advantages of less trauma, less blood loss, low cost, shorter duration of operation and shorter hospitalization time etc. It is worthly to clinical application.

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备注/Memo

备注/Memo:
国家自然科学基金青年基金项目（30901523）
更新日期/Last Update: 2016-02-16