[1]谢学然,朱培丽,乔源鑫,等.腓骨近端截骨联合关节镜下清理治疗中老年膝关节骨关节炎的临床疗效[J].中华老年骨科与康复电子杂志,2016,(04):217-221.[doi:10.3877/cma.j.issn.2096-0263.2016.04.005]
　Xie Xueran,Zhu Peili,Qiao Yuanxin,et al.Effect of proximal fibular osteotomy combined with arthroscopy debridement in senile knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(04):217-221.[doi:10.3877/cma.j.issn.2096-0263.2016.04.005]
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腓骨近端截骨联合关节镜下清理治疗中老年膝关节骨关节炎的临床疗效()
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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04期
页码:
217-221
栏目:
“不均匀沉降理论”在骨关节炎中的应用
出版日期:
2016-11-05

文章信息/Info

Title:
Effect of proximal fibular osteotomy combined with arthroscopy debridement in senile knee osteoarthritis
作者:
谢学然; 朱培丽; 乔源鑫; 宋子民
473000 南阳市骨科医院关节微创科
Author(s):
Xie Xueran;  Zhu Peili;  Qiao Yuanxin;  Song Zimin
Department of Orthopeadics Surgery, Nanyang Orthopeadics Hospital, 473000, China
关键词:
膝关节;  骨关节炎;  腓骨;  截骨术;  关节镜检查
Keywords:
Knee joint;  Osteoarthritis;  Fibular;  Osteotomy;  Arthroscopy
DOI:
10.3877/cma.j.issn.2096-0263.2016.04.005
文献标志码:
A
摘要:
目的 观察腓骨近端截骨联合关节镜下清理治疗中老年膝关节骨性关节炎的临床疗效。方法 回顾性分析 2014年 11月至 2015年 9月南阳市骨科医院收治的符合纳入标准的中老年膝关节骨关节炎患者43例，其中采用腓骨近端截骨联合关节镜下清理31例（腓骨截骨+关节镜清理组），行口服非甾体类抗炎药、中药塌渍治疗 12例（药物治疗组）。分别于治疗前、治疗后 1周、1个月、3个月、6个月、12个月，随访记录并比较两组患者疼痛视觉模拟评分（VAS）、美国特种外科医院（HSS）膝关节评分及美国膝关节协会评分（KSS）的变化，并评价患者满意度。结果 所有患者均获得随访，随访时间 2～12 个月，平均（5.6±1.2）个月，其中腓骨截骨 +关节镜清理组满意度（77.4%）显著高于药物治疗组（41.6%），差异有统计学意义（c2 =18.977，P=0.001）。治疗前腓骨截骨+关节镜清理组与药物治疗组的 VAS、HSS 及 KSS 评分比较，差异均无统计学意义，治疗后腓骨截骨+关节镜清理组患者的 VAS 评分（2.6±1.2）分低于药物治疗组（3.6±0.9）分，HSS（70±7）分及KSS评分（69±7）分高于药物治疗组（62±5）分、（58±4）分，差异均具有统计学意义（t=2.159，t=2.569，t=4.466，P＜0.05）。结论 腓骨近端截骨联合关节镜下清理治疗中老年膝关节骨关节炎可减轻患者疼痛，改善膝关节功能，疗效优于口服非甾体类抗炎药、中药塌渍。
Abstract:
Objective To observe the clinical effect of proximal fibular osteotomy combined with arthroscopy debridement in the treatment of senile knee osteoarthritis. Methods A retrospective analysis was performed in 43 senile knee osteoarthritis in Nanyang Orthopeadics Hospital from November 2014 to September 2015. Thirty one patients were treated with proximal fibular osteotomy combined with arthroscopy debridement, 12 patients were treated with steroidal anti- inflammatory drugs and traditional Chinese medicine. Visual analogue score (VAS), hospital for special surgery (HSS) knee score and keen society score (KSS) of the two groups were recorded before and 1 week, 1 month, 3 months, 6 months and 12 months after the treatment respectively. VAS, HSS and KSS were compared between two groups and patient satisfation were evaluated. Results All 43 cases got satisfied 2- 12 months follow- up, with an average of (5.6 ± 1.2) months. The patient satisfation in proximal fibular osteotomy combined with arthroscopy debridement group (77.4%) was obviously higher than that in medication group (41.6%) with statictical significance (c2=18.977, P=0.001). There were no statistical difference of VAS, HSS and KSS between two groups before treatment. While the VAS in proximal fibular osteotomy combined with arthroscopy debridement group [(2.6 ± 1.2) points] was significant lower than that in medication group [(3.6 ± 0.9) points], HSS and KSS in proximal fibular osteotomy combined with arthroscopy debridemen group [(70±7) and (69±7) points] were all significant higher than that in medication group [(62±5) and (58 ± 4)] after treatment, with statistical significance (t=2.159, t=2.569, t=4.466, P<0.05). Conclusions Proximal fibular osteotomy combined with arthroscopy debridement can effectively alleviate pain and improve the function of knee joint for senile KOA. It has better clinical results than non steroidal antiinflammatory drugs combined with traditional Chinese medicine group.

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备注/Memo

备注/Memo:
基金项目：北京市科委生命科学领域前沿技术培育项目（Z131100005213004）
更新日期/Last Update: 2017-04-01