[1]白云波,魏文华,李健阳,等.关节镜清理结合腓骨近端截骨术治疗膝关节骨关节炎的疗效研究[J].中华老年骨科与康复电子杂志,2017,(02):97-102.[doi:10.3877/cma.j.issn.2096-0263.2017.02.006]
　Bai Yunbo,Wei Wenhua,Li Jianyang,et al.Clinical effectiveness of limited arthroscopic debridement combined with proximal fibular osteotomy in treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(02):97-102.[doi:10.3877/cma.j.issn.2096-0263.2017.02.006]
点击复制

关节镜清理结合腓骨近端截骨术治疗膝关节骨关节炎的疗效研究()
分享到：

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02期
页码:
97-102
栏目:
“不均匀沉降理论”在骨关节炎中的应用
出版日期:
2017-03-25

文章信息/Info

Title:
Clinical effectiveness of limited arthroscopic debridement combined with proximal fibular osteotomy in treatment of knee osteoarthritis
作者:
白云波 1; 魏文华 1; 李健阳 1; 陈鑫 1; 杨杨 2; 荆长富 2; 吴庆田 3
572000 三亚市人民医院运动医学科 1；155100 双鸭山煤炭总医院骨科 2；154007 佳木斯大学基础医学院 3
Author(s):
Bai Yunbo;  Wei Wenhua;  Li Jianyang;  Chen Xin;  Yang Yang;  Jing Changfu;  Wu Qingtian
1Department of Sports Medicine, People’s hospital of sanya, Sanya 572000, China. 2Department of Orthopaedics, Shuangyashan coal general hospital, Shuangyashan 155100, China. 3Jiamusi University, Jiamusi 154002, China
关键词:
关节镜检查;  腓骨;  截骨术;  骨关节炎
Keywords:
Arthroscopy;  Fibular;  Osteotomy;  Osteoarthritis
DOI:
10.3877/cma.j.issn.2096-0263.2017.02.006
文献标志码:
A
摘要:
目的 研究膝关节镜清理结合腓骨近端截骨术治疗膝关节骨关节炎的临床效果。方法回顾性收集 2013年 8月至 2015年 8月双鸭山煤炭总医院及三亚人民医院膝关节骨关节炎患者 36例，根据手术方式不同分为关节镜清理组（n=20）和关节镜清理+腓骨近端截骨术组（n=16）。分别于术前、术后 3 个月、术后 1 年随访并比较两组患者的美国特种外科医院（HSS）膝关节评分、疼痛视觉模拟评分（VAS）、膝关节相关角[股骨干与股骨双髁连线夹角（简称 F角）、胫股关节间隙角（简称 JS角）、股骨胫骨角（简称 FT角）]。结果 36例患者均获得随访，随访时间为 11～22个月，平均（18.8±6）个月。关节镜清理组术前 HSS评分为（44±6）分，术后3个月增加至（72±5）分，术后1年增加至（81±6）分，术前VAS评分为（7.24±0.19）分，术后3个月减少至（3.45±0.17）分，术后1年减少至（2.81±0.21）分，且差异均有统计学意义（P＜0.01）；关节镜清理+腓骨近端截骨术组术前 HSS评分为（45.2±5.1）分，术后 3个月增加至（87.9±6.2）分，术后 1年增加至（91.4±6.9）分，术前 VAS评分为（7.49±0.15）分，术后 3个月减少至（1.19±0.27）分，术后 1年减少至（1.04±0.19）分，且差异均有统计学意义（P＜0.01），关节镜清理+腓骨近端截骨组患者术后 3个月及 1年 HSS评分、VAS评分均优于关节镜清理组（P＜0.01）。关节镜清理+腓骨近端截骨术组F角、 JS角、FT角分别由术前的（83.5±1.9）°、（3.1±2.1）°、（183.1±2.47）°减小至术后3个月的（81.4±1.5）°、（1.5±1.8）°、（180.1±2.1）°及术后 1年的（81.4±1.5）°、（1.4±1.1）°、（180.5±1.74）°，差异均有统计学意义（P＜0.05）。结论 关节镜有限清理结合腓骨近端截骨术不但能处理关节内病变，同时可以改善下肢力线，延缓骨关节炎发展，临床疗效满意。
Abstract:
Objective To study the clinical efficacy of arthriscopic debridement combined with proximal fibular osteotomy in the treatment of knee osteoarthritis（KOA）. Methods A retrospective study was performed in 36 KOA cases from August 2013 to August 2015 in Sanya People’s Hospital and Shuangyashan Coal General Hospital. They were divided into two groups based on different surgeries, 20 patients in knee arthroscopy debridement group and 16 in limited arthroscopic debridement combined with proximal fibular osteotomy group. Evaluation index including hospital for special surgery knee score (HSS), visual analogue score (VAS), Femoral shaft double condyle angle (F angle), joint gap angle, femorotibial angle (JS angle) of two groups were evaluated before operation, 3 months and 1 year after operation. Results Thirty-six cases receieved an average of (18.8±6) months (range, 11-2 months) followed-up, The HSS of knee arthroscopy debridement group increased from (44±6) preoperative to (72±5) at 3 months and (81±6) at 1 year postoperative, and VAS decreased from (7.49±0.15) preoperative to (1.19±0.27) at 3 months and (2.81±0.21) 1 year postoperative; The HSS of limited arthroscopic debridement combined with proximal fibular osteotomy group increased from (45.2±5.1) preoperative to (87.9±6.2) at 3 months and (91.4±6.9) 1 year postoperative, and the VAS decreased from (7.49±0.15) preoperative to (1.19±0.27) at 3 months and (1.04 ± 0.19) 1 year postoperative. The HSS and VAS in limited arthroscope debtridement combined with proximal fibular osteotomy group were significnat superior to that in the arthoscopy debridement group (P< 0.01). In limited arthroscopic debridement combined with proximal fibular osteotomy group, the F angle, JS angle and FT angle were significantly decreased from (83.5±1.9)°, (3.1±2.1)°, (183.1±2.47)° preoperative to (81.4 ± 1.5)° , (1.5 ± 1.8)° , (180.1 ± 2.1)° 3 months and (81.4 ± 1.5)° , (1.4 ± 1.1)° , (180.5 ± 1.74)° 1 year postoperative. All data were statistically significant compared to preoperative data (P<0.05). Conclusion Arthroscopic debridement and postoperative rehabilitation can effectively treat intra- articular lesions, improve the axial alignment of the lower extremity and slow down the progression of osteoarthritis with better clinical results.

相似文献/References:

[1]王春生 金辽沙 杨佩 张子琦 王坤正.腓骨中上段截除术对踝关节功能的影响[J].中华老年骨科与康复电子杂志,2016,(01):7.[doi:10.3877/cma.j.issn.2096-0263.2016.01.002]
　Wang Chunsheng,Jin Liaosha,Yang Pei,et al.Influence of partial resection of middle-upper fibula on ankle joint[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):7.[doi:10.3877/cma.j.issn.2096-0263.2016.01.002]
[2]徐彬 马俊 聂涌 黄泽宇 谭震 裴福兴.腓骨近端截骨术治疗膝关节骨关节炎的早期临床疗效研究[J].中华老年骨科与康复电子杂志,2016,(01):11.[doi:10.3877/cma.j.issn.2096-0263.2016.01.003]
　Xu Bin,MaJun,Nie Yong,et al.Early clinical effect of proximal fibular osteotomy on the treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):11.[doi:10.3877/cma.j.issn.2096-0263.2016.01.003]
[3]周磊 曲铁兵 林源 潘江 王志为 任世祥 陈彤 温亮 张博 马德思.腓骨近端截骨术治疗膝关节骨关节炎的疗效评价[J].中华老年骨科与康复电子杂志,2016,(01):16.[doi:10.3877/cma.j.issn.2096-0263.2016.01.004]
　Zhou Lei,Qu Tiebing,Lin Yuan,et al.Evaluation of proximal fibula osteotomy for treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):16.[doi:10.3877/cma.j.issn.2096-0263.2016.01.004]
[4]王英明 孔荣 禹德万 朱晨 官建中 周建生.腓骨近端截骨联合关节镜下膝关节清理治疗膝关节内侧间室骨关节炎的临床疗效[J].中华老年骨科与康复电子杂志,2016,(01):21.[doi:10.3877/cma.j.issn.2096-0263.2016.01.005]
　Wang Yingming,Kong Rong,Yu Dewan,et al.Effect of proximal fibular osteotomy combined with arthroscopic debridement on medial compartment knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):21.[doi:10.3877/cma.j.issn.2096-0263.2016.01.005]
[5]徐明 付志厚 孙海宁 曲新涛 于秀淳.腓骨近端截骨与单髁关节置换治疗膝关节内侧单间室骨关节炎的疗效比较[J].中华老年骨科与康复电子杂志,2016,(01):26.[doi:10.3877/cma.j.issn.2096-0263.2016.01.006]
　Xu Ming,Fu Zhihou,Sun Haining,et al.Comparison study of proximal fibular osteotomy versus unicompartmental knee arthroplasty for medialcompartment osteoarthritis of the knee[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):26.[doi:10.3877/cma.j.issn.2096-0263.2016.01.006]
[6]李博　李计东　刘丽君　曲磊　刘丽霞　贾媛媛　王海红　刘军.腓骨近端截骨术与口服药物治疗膝关节骨关节炎的对比研究[J].中华老年骨科与康复电子杂志,2016,(01):32.[doi:10.3877/cma.j.issn.2096-0263.2016.01.007]
　Li Bo,Li Jidong,Liu Lijun,et al.Therapeutic effect analysis of proximal fibular osteotomy for the treatment of patients withknee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):32.[doi:10.3877/cma.j.issn.2096-0263.2016.01.007]
[7]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.[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,(02):38.[doi:10.3877/cma.j.issn.2096-0263.2016.01.008]
[8]郑艮强 吴斗 赵恩哲 田亮 郜振武 郑上团 刘强.膝关节周围截骨术对膝关节骨关节炎伴内翻畸形的治疗策略[J].中华老年骨科与康复电子杂志,2016,(01):44.[doi:10.3877/cma.j.issn.2096-0263.2016.01.009]
[9]孙佳冰　付春江　邹吉龙　陈洪均　王旭明　张鹏　毕郑刚.膝关节软骨剥脱分期对腓骨近端截骨治疗膝关节骨关节炎的指导意义[J].中华老年骨科与康复电子杂志,2016,(01):50.[doi:10.3877/cma.j.issn.2096-0263.2016.01.010]
[10]吴碧 王跃 郝鹏.腓骨近端截骨术治疗膝关节骨关节炎的研究进展[J].中华老年骨科与康复电子杂志,2016,(01):54.[doi:10.3877/cma.j.issn.2096-0263.2016.01.011]

备注/Memo

备注/Memo:
基金项目：黑龙江省自然科学基金面上项目（D201067）
更新日期/Last Update: 2017-04-01