腓骨近端截骨联合关节镜手术治疗膝关节内侧间室骨关节炎的疗效分析  

Analysis of therapeutic effect of proximal fibula osteotomy combined with arthroscopic surgery on medial compartment knee osteoarthritis

作　　者：李仕臣 王文革[1] 赵二龙[1] Li Shichen;Wang Wenge;Zhao Erlong(Department of Orthopedics, The Fourth People Hospital, Linfen 041000, China)

机构地区：[1]山西省临汾市第四人民医院骨科,041000

出　　处：《中华老年骨科与康复电子杂志》2017年第4期238-243,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：山西省医学重点学科项目资金(GL201536)

摘　　要：目的探讨联合应用腓骨近端截骨和关节镜手术治疗膝关节内侧间室骨关节炎的临床效果。方法回顾性分析山西省临汾市第四人民医院2013年2月至2015年4月收治且符合纳入标准的膝关节内侧间室骨关节炎患者26例。根据手术方式分为A组(行腓骨近端截骨结合关节镜手术,n=16)、B组(行单纯腓骨近端截骨术,n=10)。随访并比较两组患者术后的满意度、膝关节内侧间隙增宽情况、力线外移情况及膝关节Lysholm评分。结果 26例患者均获得随访,A组随访时间6~20个月,平均(10±5)个月;B组随访时间6~18个月,平均(9±4)个月。两组患者术后1、3、6个月各时间段满意度均较高(A组:75%、81.25%、93.75%,B组:60%、60%、80%),组间比较差异无统计学意义;与术前相比,A组与B组患者术后6个月时内侧间隙均明显增宽,差异有统计学意义(t=2.991,t=2.664,P<0.05),下肢力线明显外移,差异均具有统计学意义(t=5.964,t=3.484,P<0.05),组间比较差异无统计学意义;A组患者术后1、6个月膝关节Lysholm评分均较B组高,差异有统计学意义(F=3.221,F=3.672,P<0.05),两组均无严重手术并发症。结论腓骨近端截骨手术治疗膝关节内侧间室骨关节炎能使下肢力线外移、有效缓解膝关节内侧疼痛,联合应用关节镜可进一步改善膝关节关节功能,效果肯定,值得进一步临床推广。Objective To investigate the clinical outcome of proximal fibula osteotomy combined with arthroscopic surgery in treatment of medial compartment knee osteoarthritis.Methods A retrospective study was performed in26cases of compartment knee osteoarthritis from February2013to April2015.according to the surgical method,the enrolled patients were divided into two groups:Group A(n=16)were treated by proximal fibula osteotomy combined with arthroscopic surgery while Group B(n=10)only got proximal fibula osteotomy.Postoperative satisfaction,knee medial broadening gap offshoring,power line and the Lysholm knee scores were compared between two groups.Results All26patients were followed up with a time span of6-20months(Group A,average10±5)and6-18months(Group B,average9±4).There were high satisfaction in the two groups at1,3,6months after operation(Group A:75%,81.25%,93.75%,Group B:60%,60%,80%),compared with the preoperative,the inside clearance of the patients in two groups were significantly broader at6months postoperative(t=2.991,t=2.664,P<0.05),the limb alignment was significantly outside moved(t=5.964,t=3.484,P<0.05),while there were no statistically differences between two groups.The patients'knee joint Lysholm scores in Group A were significantly higher than the Group B at1,6months postoperative,the differences were statistically significant(F=3.221,F=3.672,P<0.05),all the patients in two groups had no serious complications.Conclusion Proximal fibula osteotomy combined with arthroscopic surgery can outside move the limb alignment,relieve pain and improve joint function in patients with medial compartment knee osteoarthritis,which is an effective way for medial compartment knee osteoarthritis,deserves further clinical promotion.

关 键 词：腓骨 截骨术 关节镜检查 膝关节 骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]