[1]赵恩哲,郑艮强,梁伟,等.腓骨近端截骨术治疗膝关节骨关节炎的临床疗效及影像学评价[J].中华老年骨科与康复电子杂志,2017,(01):32-37.[doi:10.3877/cma.j.issn.2096-0263.2017.01.007]
　Zhao Enzhe,Zheng Genqiang,Liang Wei,et al.Clinical effect and radiographic evaluation of proximal fibula osteotomy for the treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):32-37.[doi:10.3877/cma.j.issn.2096-0263.2017.01.007]
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腓骨近端截骨术治疗膝关节骨关节炎的临床疗效及影像学评价()
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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:
32-37
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:
Clinical effect and radiographic evaluation of proximal fibula osteotomy for the treatment of knee osteoarthritis
作者:
赵恩哲 1; 郑艮强 2; 梁伟 2; 田亮 2; 郜振武 2; 吴斗 1; 2; 刘强 1; 2
030001 山西医科大学 1；山西医科大学附属大医院骨科 2
Author(s):
Zhao Enzhe1;  Zheng Genqiang2;  Liang Wei2;  Tian Liang2;  Gao Zhenwu2;  Wu Dou1; 2;  Liu Qiang1; 2
1Shanxi Medical University; 2Department of Orthopedics, Affiliated DAYI Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
骨关节炎; 膝;  腓骨;  截骨术;  不均匀沉降
Keywords:
Osteoarthritis;  knee;  Fibula;  Osteotomy;  Uneven settlement
DOI:
10.3877/cma.j.issn.2096-0263.2017.01.007
文献标志码:
A
摘要:
目的 评价腓骨近端截骨术治疗膝关节骨关节炎的初期疗效。方法 回顾性收集2015年2月至 2016年 3月于山西大医院骨科行腓骨近端截骨术治疗的膝关节内侧间室骨关节炎患者 14例（16膝），于术前、术后 3 d、1个月、3个月及 6个月记录疼痛视觉模拟评分（VAS），美国膝关节协会评分（KSS），胫股角（FTA）、胫骨平台内翻角（TP-TSA）、髋-膝-踝角（HKA）及膝关节外侧间室高度的变化。结果 14例（16膝）患者均获得随访，随访时间平均（6±4）个月；手术时间平均（76±30）min；术中出血量平均（25±11）ml；术后住院时间平均（5±3）d。至末次随访时，14例（16膝）患者VAS疼痛评分由术前（6.6±1.4）分降至（2.9±1.8）分、 KSS临床评分由术前（51±14）分升至（77±15）分，KSS功能评分由术前（34±18）分升至（67±23）分，胫骨平台内翻角由术前（83.1±2.1）°增大至（84.4±2.5）°，膝关节外侧间室高度由术前（0.731±0.096）cm 减小至（0.674±0.098）cm，差异均有统计学意义（P＜0.05），胫股角无明显改变；8例患者术前术后均拍摄双下肢全长负重X线，HKA由术前（172.1±3.9）°增大至（174.6±2.6）°，差异有统计学意义（t=-2.884，P＜0.05）。结论 腓骨近端截骨术治疗膝内侧间室骨关节炎的初期疗效良好，能明显缓解患者膝关节疼痛症状，改善膝关节功能，提高生活质量。
Abstract:
Objective To evaluate early clinical effect of proximal fibula osteotomy in the treatment of knee osteoarthritis (OA). Methods A retrospective study was performed in 14 patients (16 knees) with medial compartment OA who underwent proximal fibular osteotomy in Affiliated DAYI Hospital of Shanxi Medical University from February 2015 to March 2016. The visual analogue scale (VAS), the American knee society score (KSS), the femorotibial angle (FTA), the tibial plateau-tibial shaft angle (TP-TSA), the hip-kneeankle angle (HKA) and the distance of the lateral knee joint space were evaluated at 3 days, 1 month, 3 months, 6 months after surgery. Results All 14 patients (16 knees) were followed-up for (6±4) months. The average operation duration was (76 ± 30) min, the mean operative blood loss was (25 ± 11) ml and average length of postoperative hospital stay was (5 ± 3) d. At the last follow- up, the VAS decreased to (2.9 ± 1.8) from preoperative (6.6±1.4), the KSS knee clinical score increased to (77±15) from preoperative (51±14) and KSS functional score increased to (67±23) from preoperative (34±18), the TP-TSA increased to (84.4±2.5)° from preoperative (83.1±2.1)°, the lateral knee joint space height decreased to (0.674±0.098) cm from preoperative (0.731±0.096) cm, with statistical significance of all (P<0.05), while there was no statistical difference in FTA before and after operation. Eight cases were taken X-ray films of total limb length before and after surgery, and their HKA increased from (172.1 ± 3.9)° to (174.6 ± 2.6)° , with statistical significance (t=- 2.884, P<0.05). Conclusions The proximal fibular osteotomy showed excellent early functional outcome in the treatment of knee osteoarthritis. It can significantly relieve pain, improve the knee function and life quality of KOA patients.

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备注/Memo

备注/Memo:
基金项目：山西省科技基础条件平台项目（2015091002-0105）
更新日期/Last Update: 2017-04-01