不同手术方式治疗双膝关节骨性关节炎效果及对足底压力的影响  

Effects of Different Surgical Methods on Patients with Osteoarthrosis of Both Knees and Its Effect on Plantar Pressure

作　　者：高宇 肖强 赵丽莉 邢文钊[2] 

机构地区：[1]张家口市第一医院骨外科,河北张家口075000 [2]河北医科大学第三医院骨伤科,石家庄050051

出　　处：《解放军医药杂志》2018年第2期62-65,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省医学科学研究重点课题计划(20150722)

摘　　要：目的观察一侧全膝关节置换术联合对侧腓骨近端截骨术治疗双膝关节骨性关节炎效果及对足底压力的影响。方法选择2015年1月—2017年1月张家口市第一医院收治的双侧膝关节骨性关节炎54例,按治疗方法分为研究组和对照组,每组27例54膝。对照组采用双侧全膝关节置换术,研究组采用一侧全膝关节置换术联合对侧腓骨近端截骨术。观察2组手术相关指标,手术前、术后1、3、6个月美国特种外科医院膝关节评分(HSS评分),手术前后足底各区达峰值压力(Max-F)差值。结果研究组手术失血量、术后输血量、术后总引流量、住院时间及住院总费用均低于对照组(P<0.05)。对照组和研究组重侧肢和研究组术前后Max-F差值比较差异无统计学意义(P>0.05)。2组手术前后HSS评分比较差异均无统计学意义(P>0.05)。结论一侧全膝关节置换术联合对侧腓骨近端截骨术治疗双膝骨性关节炎近期疗效较好,可改善患肢术后力线和跛行状态,且可降低手术损伤。Objective To observe effect of unilateral total knee arthroplasty combined with opposite proximal fibular osteotomy in treatment of patients with osteoarthritis of both knees and its effect on plantar pressure. Methods A total of 54 patients with osteoarthritis of both knees admitted during January 2015 and January 2017 were divided into observation group( n = 27,54 knees) and control group( n = 27,54 knees) according to surgical methods. Control group was treated with simultaneous bilateral total knee arthroplasty,while observation group was treated with unilateral total knee arthroplasty combined with opposite proximal fibular osteotomy. Operative indexes,hospital for special surgery( HSS)scores before and in 1 month,3 months and 6 months after surgery,and maximal force( Max-F) difference values of plantar areas before and after surgery. Results Values of operative volume of blood loss,postoperative volume of blood transfusion,postoperatively total drainage volume,hospitalization time and total hospitalization expenses in observation group were significantly lower than those in control group( P < 0. 05). There were no significant differences in Max-F difference values of badly lateral limb before and after surgery in two groups and the values before and after surgery in observation group( P > 0. 05). There were no significant differences in HSS scores before and after surgery in two groups( P > 0. 05). Conclusion Unilateral total knee arthroplasty combined with opposite proximal fibular osteotomy in treatment of patients with osteoarthritis of both knees may achieve good short-term effect,improve postoperative line of force line and limp state of affected limbs and reduce operative injury.

关 键 词：骨关节炎 膝 全膝关节置换术 截骨术 足底压力 

分 类 号：R684.3[医药卫生—骨科学]