[1]霍丽丽,颉朝阳,崔小雷.腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎的疗效分析[J].中华老年骨科与康复电子杂志,2017,(05):306-309.[doi:10.3877/cma.j.issn.2096-0263.2017.05.011]
　Huo Lili,Xie Chaoyang,Cui Xiaolei.Proximal tibia and fibula osteotomy combined with arthroscopic joint debridement in treatment of knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):306-309.[doi:10.3877/cma.j.issn.2096-0263.2017.05.011]
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腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎的疗效分析()
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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05期
页码:
306-309
栏目:
“不均匀沉降理论”在骨关节炎中的应用
出版日期:
2017-09-18

文章信息/Info

Title:
Proximal tibia and fibula osteotomy combined with arthroscopic joint debridement in treatment of knee osteoarthritis
作者:
霍丽丽; 颉朝阳; 崔小雷
053000 衡水市第四人民医院关节骨科
Author(s):
Huo Lili;  Xie Chaoyang;  Cui Xiaolei
Department of Orthopedic Joints of Hengshui No. 4 People’s hospital, Hengshui, 053000, China
关键词:
膝关节;  骨关节炎;  截骨术;  膝关节镜;  关节清理
Keywords:
Knee;  Ostarthritis;  Osteotomy;  Knee arthroscopy;  Joint cleaning
DOI:
10.3877/cma.j.issn.2096-0263.2017.05.011
文献标志码:
A
摘要:
目的 探讨腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎的疗效。方法 回顾性分析2014年4月至2015年8月行腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎患者32例（35膝），其中男性7例（22%），女性25例（78%）。年龄43～71岁，平均（53±3）岁；左膝13例（41%），右膝16例（50%），双膝3例（9%），膝关节骨性关节炎分级Ⅰ级0例（0%），Ⅱ级5例（16%），Ⅲ级20例（62%），Ⅳ级7例（22%），分别在术前、术后一个月对患膝进行美国特种外科医院膝关节评分（HSS），疼痛视觉模拟评分（VAS）及膝关节内侧间室高度变化的比较。结果 所有患者均获得满意随访，随访时间3～15个月，平均（9±2）个月。HSS评分术前（52.7±1.3）分改善至术后末次随访（80.5±0.9）分，差异有统计学意义（t=18.930，P＜0.01），其中优26膝、良7膝、可2膝，术后优良率达94.3%。VAS评分术前的（6.59±0.21）分降至术后一个月的（2.34±0.16）分，差异有统计学意义（t=20.655，P＜0.01），内侧间室高度由术前的（2.90±0.12）mm提高至术后的（5.97±0.21）mm，差异具有统计学意义（t=12.921，P＜0.01）。所有患者中4例出现腓浅神经损伤，无深静脉血栓形成、感染等并发症发生。结论 腓骨近端截骨联合膝关节镜下关节清理术治疗膝关节骨性关节炎可减轻患者疼痛，改善膝关节功能及影像学表现，术后并发症少。
Abstract:
Objective To explore the effect of proximal fibula osteotomy combined with arthroscopic joint debridement in the treatment of knee osseousarthritis. Methods A retrospective analysis was done in 32 knee osteoarthritis (35 knees) from April 2014 to August 2015 treated with proximal fibula osteotomy combined with knee arthroscopic debridement. There were 7 males (22%) and 25 females (78%) with an average of 53±3 years (43-71 years), left in 13 cases (41%) and right in 16 patients (50%), bilateral in 3 patients (9%). There was no Grade I (0%) knee osteoarthritis, 5 cases were Grade II (16%), 20 cases were Grade III (62%) and 7 Grade IV (22%). Before surgery and at one month postoperatively, respectively recorded and compared the knee using United States Hospital of special surgery knee score（HSS）, visual analog scale（VAS）and changes in the medial compartment of knee joint. Results All patients were satisfactorily followed up for 3 to 15 months, average 9±2 months. Preoperative HSS score were 43±3 points, lower than one month postoperative (87.7±3.3 points), difference was statistically significant (t=18.930, P<0.01). Overall 26 knees were excellent, 7 were Good and 2 knees were fair, The excellent and good rate was 94.3%. Preoperative VAS score were 6.8±0.5 points, higher than one month postoperative (2.5±0.5 points), difference was statistically significant (t=20.655, P<0.01). Height of the medial compartment was improved from 2.90+0.12 mm preoperatively to 5.97+0.21 mm postoperatively, difference was statistically significant (t=12.921, P<0.05). Superficial nerve injury occurred in 4 patients. No deep venous thrombosis, infection and other complications occurred. Conclusion Proximal osteotomy combined with knee arthroscopic debridement for knee osteoarthritis can relieve pain, improving the function of knee joint and imaging performance, reducing the postoperative complications.

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更新日期/Last Update: 2017-09-15