腓骨近端截骨联合关节镜下膝关节清理治疗膝关节内侧间室骨关节炎的临床疗效  

Effect of proximal fibular osteotomy combined with arthroscopic debridement on medial compartment knee osteoarthritis

作　　者：王英明[1] 孔荣[1] 禹德万[1] 朱晨[1] 官建中[2] 周建生[2] 

机构地区：[1]安徽省立医院骨一科,合肥230001 [2]蚌埠医学院附属医院,233004

出　　处：《中华老年骨科与康复电子杂志》2016年第1期21-25,共5页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金(81401815)

摘　　要：目的比较腓骨近端截骨联合关节镜下膝关节清理与单纯关节镜下膝关节清理术治疗膝关节内侧间室骨关节炎的疗效。方法回顾性分析2013年1月至2015年6月收治的符合纳入及排除标准的膝关节骨关节炎患者17例，其中单纯行关节镜下关节腔清理术5例（A组），行腓骨近端截骨联合关节镜下膝关节清理12例（B组）。A组男2例，女3例，年龄55～65岁，平均（60±4）岁。B组男4例，女8例，年龄56～77岁，平均（64±6）岁。分别术后3d、1个月、3个月、6个月及之后每半年随访并比较两组患者的疼痛视觉模拟评分（visual analogue score，VAS）、美国特种外科医院（hospital for special surgery，HSS）膝关节评分及胫股角（femur-tibia angle，FTA）的变化。结果17例患者均获得满意随访，随访时间3～12个月，平均（5．9±1．0）个月。术前A组与B组的VAS评分、HSS评分及FTA比较，差异均无统计学意义（t=-1．050，t=-0．449，t=-0．686，P〉0．05），术后A组患者的VAS评分及FTA高于B组，HSS评分低于B组，差异具有统计学意义（t=-5．219，t=3．447，t=-11．199，P〈0．05）。结论腓骨近端截骨联合关节镜下膝关节清理术治疗膝关节内侧间室骨关节炎患者的效果优于单纯关节镜下膝关节清理术，术后可明显降低患者疼痛，改善膝关节结构及功能，值得临床推广。Objective To investigate the effect of proximal fibular osteotomy combined with arthroscopic debridement in the treatment of medial compartment knee osteoarthritis. Methods From January 2013 to June 2015, 17 patients who suffered medial compartment knee osteoarthritis were allocated into two groups： group A （n=5） and group B （n=12）. Patients in group A received arthroscopic debridement while group B got additional proximal fibular osteotomy. Visual analogue score（VAS）, hospital for special surgery （HSS） knee score and change of femur-tibia angle （FTA）were measured separately and comparsion was done between two groups. Results All 17 cases got satisfied follow-up for 3-12 months, mean time was （5.9±1.0） months. There were no statistically differences in VAS, HSS and FTA between group A and group B preoperatively respectively （t=1.050, t=0.449, t=0.686, P〉0.05）. While postoperatively, the VAS and FTA of group A was higher than that in group B, the HSS of group A was lower than that in group B, the differences was statictically significant （t=5.219,t=3.447, t=11.199, P〈0.05）. Conclusions Proximal fibular osteotomy combined with arthroscopic debridement was a more effective treatment for medial compartment knee osteoarthritis than single arthroscopic debridement. Advantages include pain reduction, function and construction improvements of the knee were observed that can benefit the clinics.

关 键 词：骨关节炎 膝 腓骨 截骨术 关节镜检查 

分 类 号：R687.3[医药卫生—骨科学]