[1]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):11-15.[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,(01):11-15.[doi:10.3877/cma.j.issn.2096-0263.2016.01.003]
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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()
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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:
11-15
栏目:
临床论著
出版日期:
2016-02-05

文章信息/Info

Title:
Early clinical effect of proximal fibular osteotomy on the treatment of knee osteoarthritis
作者:
徐彬 马俊 聂涌 黄泽宇 谭震 裴福兴
四川大学华西医院骨科
Author(s):
Xu Bin;  MaJun;  Nie Yong;  Huang Zeyu;  Tan Zhen;  Pei Fuxing
Department of Orthopaedics, West China Hospital, SichuanUniversity, Chengdu 610061,China
关键词:
骨关节炎; 膝; 　腓骨; 　截骨术; 　治疗结果; 　术后并发症
Keywords:
Osteoarthritis;  knee; 　Fibula; 　Osteotomy; 　Treatment outcome; 　Postoperativecomplications
DOI:
10.3877/cma.j.issn.2096-0263.2016.01.003
摘要:
目的　探讨腓骨近端截骨术治疗膝关节骨关节炎的早期临床疗效。方法　回顾性收集2015 年4 月至2015 年10 月四川大学华西医院行腓骨近端截骨术的患者共15 例（18 膝），统计患者一般资料及住院时间、手术时间及术后并发症，随访并比较患者在术前、术后1 d、1 个月、3个月、6 个月时的内侧间隙压痛、患膝活动度（range of motion，ROM）、疼痛视觉模拟评分（visualanalogue scale，VAS）、美国特种外科医院（hospital for special surgery，HSS）膝关节评分及拍摄X线片测量其髋膝踝角（hip-knee-ankle angle，HKA），观察患者临床疗效及并发症发生情况。结果15 例患者（18 膝）均完成1 个月随访，其中11 例（12 膝）完成3 个月随访，8 例（9 膝）完成6 个月随访。手术时间平均（26±6）min，住院时间平均（4. 8±1. 7）d，与术前相比，术后1 d、1 个月、3 个月、6 个月患者的VAS 评分均显著降低（F=15.923，P ＜ 0.01）、HSS 评分明显升高（F=8.969，P ＜ 0.01）。手术前后ROM 及HKA 角无明显改变，内侧间隙压痛均缓解，部分患者不同程度地出现踝关节背伸肌力下降、局部感觉减退、肿胀及疼痛，随访时症状逐渐缓解。结论　腓骨近端截骨术操作简单、术后恢复快、并发症少、可有效缓解膝关节内侧骨关节炎患者的疼痛并改善关节功能，是治疗膝关节内侧骨关节炎的可选手术方法。
Abstract:
Objective　To study the early clinical effect on the treatment of knee osteoarthritisby proximal fibular osteotomy. Methods　The data of 15 patients (18 knees) received proximal fibularosteotomy in west China hospital, from April 2015 to October 2015 were collected retrospectively. Theobservation was performed at 1 day, 1 month, 3 months, 6 months after the operation. The general data,the length of hospital stay, the duration of operation and complications were collected, the positive rate ofpressing pain in medial compartment, the range of motion (ROM), visual analogue scale (VAS), hospitalfor special surgery (HSS) knee score and the hip-knee-ankle angle (HKA) were evaluated. Results 15cases (18 knees) accepted 1 month follow-up visit, 11 cases (12 knees) accepted 3 month follow-up visit,8 cases (9 knees) accepted 6 month follow-up visit. The average duration of operation was (26±6) min, theaverage duration of operation was (4.8±1.7) d, the differences of VAS and HSS knee score between preoperationand 1 day, 1 month, 3 months, 6 months post-operation were statistically significant (F=15.923,P<0.01; F=8.969, P<0.01). There was no statistical difference about ROM and HKA between preoperationand post-operation. The pressing pain in medial compartment was relieved. The complicationsincluded decreasing of dorsiflexsion muscle strength, partial hypesthesia, swell and pain. ConclusionWith the advantages including simplicity of operation, fast recovery and less complications after operation,proximal fibular osteotomy can relieve the pain and improve the function of knee for the patients withmedial compartment knee osteoarthritis, and is an acceptable method for the medial compartment kneeosteoarthritis.

参考文献/References:

1 Brody LT. Knee osteoarthritis: Clinical connections to articularcartilage structure and function [J]. Phys Ther Sport, 2015, 16(4): 301-316.
2 Bellamy N, Campbell J, Robinson V, et al. Viscosupplementation forthe treatment of osteoarthritis of the knee [J]. Cochrane Database SystRev, 2005(2): CD005321.
3 Duivenvoorden T, Brouwer RW, van Raaij TM, et al. Braces andorthoses for treating osteoarthritis of the knee [J]. Cochrane DatabaseSyst Rev, 2015, 3: CD004020.
4 Cohen D. Exercise for Osteoarthritis of the Knee [J]. Am FamPhysician, 2015, 92(9): 774-775.
5 Brouwer RW, Huizinga MR, Duivenvoorden T, et al. Osteotomy fortreating knee osteoarthritis [J]. Cochrane Database Syst Rev, 2014, 12:CD004019.
6 Hetaimish BM, Khan MM, Simunovic N, et al. Meta-analysis ofnavigation vs conventional total knee arthroplasty [J]. J Arthroplasty,2012, 27(6): 1177-1182.
7 陈伟, 陈百成, 王飞, 等. 应用不同方法治疗膝关节骨性关节炎的对比研究 [J]. 河北医科大学学报, 2015, 36(5): 600-602.
8 张英泽, 李存祥, 李冀东, 等. 不均匀沉降在膝关节退变及内翻过程中机制的研究 [J]. 河北医科大学学报, 2014, 35(2): 218-219.
9 Jayadev C, Rout R, Mcdonnell SM, et al. 211 evidence for increasedtype I collagen being in an early fearure of cartilage diseases inanteromedial osteoarthritis of the knee [J]. Osteoarthritis and Cartilage,2010, 18(2): 99-100.
10 Ledingham J, Regan M, Jones A, et al. Radiographic patterns andassociations of osteoarthritis of the knee in patients referred to hospital[J]. Ann Rheum Dis, 1993, 52(7): 520-526.
11 Bennell K, Bowles KA, Payne C, et al. Effects of laterally wedgedinsoles on symptoms and disease progression in medial kneeosteoarthritis: a protocol for a randomised, double-blind, placebocontrolled trial [J]. BMC Musculoskelet Disord, 2007, 8(1): 96.
12 Schipplein OD, Andriacchi TP. Interaction between active and passiveknee stabilizers during level walking [J]. J Orthop Res, 1991, 9(1):113-119.
13 刘月驹, 秦士吉, 李升, 等. 不均匀沉降理论在踝关节骨性关节炎中的应用 [J]. 河北医科大学学报, 2015, 36(4): 490.
14 李存祥, 贾素华, 王健, 等. 单纯腓骨截断术治疗膝骨关节炎临床研究 [J]. 中国医学创新, 2010, 7(2): 115-117.
15 Yang ZY, Chen W, Li CX, et al. Medial compartment decompressionby fibular osteotomy to treat medial compartment knee osteoarthritis: apilot study [J]. Orthopedics, 2015, 38(12): 1110-1114.

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备注/Memo

备注/Memo:
国家卫计委行业科研专项项目（201302007）
更新日期/Last Update: 2016-02-16