[1]侯永新,程伟强,张民,等.腓骨近端截骨与关节镜清理治疗内翻型膝关节骨关节炎的疗效比较[J].中华老年骨科与康复电子杂志,2016,(03):166-171.[doi:10.3877/cma.j.issn.2096-0263.2016.03.008]
　Hou Yongxin,Cheng Weiqiang,Zhang Min,et al.Comparison on the efficacy of proximal fibular osteotomy and arthroscopic debridement in treatment of varus knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(03):166-171.[doi:10.3877/cma.j.issn.2096-0263.2016.03.008]
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腓骨近端截骨与关节镜清理治疗内翻型膝关节骨关节炎的疗效比较()
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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03期
页码:
166-171
栏目:
“不均匀沉降理论”在骨关节炎中的应用
出版日期:
2016-08-05

文章信息/Info

Title:
Comparison on the efficacy of proximal fibular osteotomy and arthroscopic debridement in treatment of varus knee osteoarthritis
作者:
侯永新; 程伟强; 张民; 魏垒
030800 晋中，太谷县红十字骨科医院骨科
Author(s):
Hou Yongxin;  Cheng Weiqiang;  Zhang Min;  Wei Lei
Department of Orthopaedic, Taigu County Red Cross Orthopedic Hospital, Jinzhong 030800, China
关键词:
骨关节炎; 膝;  腓骨;  截骨术;  关节镜检查
Keywords:
Osteoarthritis;  knee;  Fibula;  Osteotomy;  Arthroscopy
DOI:
10.3877/cma.j.issn.2096-0263.2016.03.008
文献标志码:
A
摘要:
目的　比较腓骨近端截骨和单纯关节镜清理治疗内翻型膝关节骨关节炎的疗效。方法　回顾性收集 2014 年 12 月至 2015 年 3 月太谷县红十字骨科医院收治的符合纳入及排除标准的内翻型膝关节骨关节炎的患者 54 例，根据手术方式不同分为腓骨截骨组（n=27）和关节镜清理组（n=27），记录并比较两组患者术前、术后疼痛视觉模拟评分（VAS）、美国特种外科医院（HSS）膝关节评分及膝关节协会评分（KSS）。 结果　54 例患者均获得满意随访，随访时间为 6 ～ 7 个月，平均（6.5±0.3）个月。两组患者手术时间比较，差异无统计学意义（t=8.487， P ＞ 0.05）。两组患者在术前 VAS、 HSS、 KSS（临床）、 KSS（功能）评分比较差异无统计学意义（P ＞ 0.05），但在术后 1 周、 1 个月、 3 个月、 6 个月时，腓骨截骨组患者的 HSS、 KSS（临床）、 KSS（功能）评分均高于关节镜清理组， VAS 评分低于关节镜清理组，差异均有统计学意义（P ＜ 0.05）；随着时间的延长两组患者的 VAS、 HSS、 KSS（临床）、 KSS（功能）评分均较术前均明显改善（P ＜ 0.05）。腓骨截骨组患者中出现 1 例股静脉血栓、 2 例小腿肌间静脉血栓、 3 例足背麻木（其中 1 例未恢复）、 2 例切口周围轻度血肿；单纯关节镜组患者中出现 4 例关节腔积液增多、 3 例小腿肌间静脉血栓。 结论　腓骨近端截骨治疗内翻型膝关节骨关节炎效果优于关节镜清理术，可有效改善膝关节功能、减轻膝关节疼痛、术后并发症较少，是治疗内翻型膝关节骨关节炎的有效手段。
Abstract:
Objective To compare the therapeutic effect of proximal fibula osteotomy and simple arthroscopic debridement in the treatment of knee osteoarthritis. Methods Retrospective collection of 54 cases of patients with knee osteoarthritis who were treated in hospital from December 2014 to March 2015, they were randomly divided into proximal fibula osteotomy group (n=27) and arthroscopic group (n=27). Visual analogue scale (VAS), the hospital for special surgery (HSS) knee score and knee society score (KSS) were recorded and compared before and after operation. Results Fifty-four patients were followed up from 6 to 7 months, with an average of (6.5±0.3) months. The operation time of the two groups were compared, the difference was not statistically significant (t=8.487, P>0.05). And in preoperative VAS, HSS knee score, KSS (clinical), KSS (function), there were not statistically significant (P>0.05), but at 1 week, 1 month, 3 months, 6 months after operation, the KSS (clinical), KSS (function) in the proximal fibula osteotomy group were higher than that in the arthroscopic debridement group, the VAS was lower than that in the arthroscopic debridenent group. Compared with the preoperative values the VAS, HSS, KSS (clinical) and KSS (function) in the two groups were all significantly improved (P<0.05), the differences were statistically significant (P<0.05). In the proximal fibula osteotomy group, 1 case suffered from femoral vein thrombosis, 2 cases suffered from venous thrombosis in the lower leg, 3 cases suffered from foot back numbness (1 case was not improved), 2 cases of mild hematoma; In the simple arthroscopic group, 3 cases suffered from lower leg intramuscular venous thrombosis, 4 cases suffered from joint fluid accumulation. Conclusions The effect of proximal fibula osteotomy in treatment of patients with knee osteoarthritis is better than that of arthroscopic debridement, which can effectively improve the knee joint function, reduce knee pain, and less postoperative complications, and it is an effective treatment method for varus knee osteoarthritis.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81171676）
更新日期/Last Update: 2017-04-01