[1]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):16-20.[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,(01):16-20.[doi:10.3877/cma.j.issn.2096-0263.2016.01.004]
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腓骨近端截骨术治疗膝关节骨关节炎的疗效评价()
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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:
2016年01期
页码:
16-20
栏目:
临床论著
出版日期:
2016-02-05

文章信息/Info

Title:
Evaluation of proximal fibula osteotomy for treatment of knee osteoarthritis
作者:
周磊 曲铁兵 林源 潘江 王志为 任世祥 陈彤 温亮 张博 马德思
首都医科大学附属北京朝阳医院骨科
Author(s):
Zhou Lei;  Qu Tiebing; Lin Yuan;  Pan Jiang;  Wang Zhiwei;  Ren Shixiang;  Chen Tong;  Wen Liang;  Zhang Bo;  Ma Desi
Departmentof Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
关键词:
骨关节炎; 　膝关节; 　腓骨; 　截骨术; 　不均匀沉降
Keywords:
Osteoarthritis; 　Knee joint; 　Fibula; 　Osteotomy; 　Uneven settlement
DOI:
10.3877/cma.j.issn.2096-0263.2016.01.004
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2014 年11 月至2015 年8 月收治的内侧间室型膝关节骨关节炎患者5 例，其中男2 例，女3 例，年龄52 ～ 77 岁，平均年龄（61±10）岁。分别于术前、术后1 d、4 周、3 个月、6 个月随访并比较行腓骨近端截骨术前后的疼痛视觉模拟评分（visual analogue score，VAS）、美国特种外科医院（hospitalfor special surgery，HSS）膝关节评分及膝关节协会评分（keen society score，KSS），并拍摄膝关节前后位和下肢负重X 线片对比手术前后下肢力线股胫角的变化。结果　5 例患者均获得完整随访，随访时间为3 ～ 12 个月，平均（7±3）个月，手术时间（24±4）min，住院时间（4.6±0.5）d，术中出血量（17.6±2.5）ml。末次随访时，患者的VAS 评分由术前的7（0.5）分降低到3（1.5）分，差异有统计学意义（t=10.371，P ＜ 0.01）；HSS 评分由术前（59±4）分提高到（72±6）分，差异有统计学意义（t=?3.944，P ＜ 0.05）；KSS 评分由术前（62.2±2.3）分提高到（80.4±8.4）分，差异有统计学意义（t=?4.684，P＜ 0.05）。下肢力线股胫角由术前的（182.2±0.7）° 降低到（179.6±0.9）°，差异有统计学意义（t=2.339，P ＜ 0.05）。结论　腓骨近端截骨术治疗膝关节骨关节炎手术操作简单，创伤小，可明显减轻患者疼痛，改善膝关节功能，初期疗效确切。
Abstract:
Objective　To evaluate early effect of proximal fibula osteotomy in the treatmentof knee osteoarthritis (OA). Methods　From Noverber 2014 to August 2015, 5 patents with medialcompartment OA treated by proximal fibula osteotomy were analysed retrospectively, including 2 malesand 3 females with an average age of (61±10) years (range 52-77 years). They were followed up at 1 day,4 weeks, 3 months, 6 months after the operation. The visual analog scale (VAS) of the knee joint, hospitalfor special surgery (HSS) knee score, the American knee society score (KSS) and the femorotibial angle(FTA) measured by anteroposterior and lateral weight-bearing radiographs were evaluated preoperativelyand postoperatively, respectively. Results　All 5 patients were available for a mean follow-up of (7±3)months (range 3-12 months). The average operation duration was (24±4) min, the average length of staywas (4.6±0.5) d and mean operative blood loss was (17.6±2.5) ml. At final follow-up, mean VAS was3(1.5), significantly lower than the preoperative 7(0.5) (t=10.371, P<0.01). Mean HSS knee score and KSSwere (72±6) and (80±8), significantly higher than the mean preoperative score of (59±4) and (62.2±2.3)(t=?3.944, t=?4.684, P<0.05). Mean postoperative FTA was (179.6±0.9)°, significantly smaller than that measured preoperatively (182.2±0.7)°(t=2.339, P<0.05). Conclusion　The proximal fibula osteotomyfor treatment of knee osteoarthritis has the advantages of simple surgical ptocedure, less injury and cansignificantly reduce the pain, improve the knee function and obtain excellent early curative effect.

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备注/Memo

备注/Memo:
卫生部公益性行业科研专项基金（201302007）
更新日期/Last Update: 2016-02-16